| 杨 蓉,胡 峥,刘 栋,李怡帆,郭瑞雪,刘 裴.急性心肌梗死患者PCI术后心室重构患者血清Hcy、CysC、MMP-1、NGAL的表达及临床意义[J].,2021,(18):3524-3528 |
| 急性心肌梗死患者PCI术后心室重构患者血清Hcy、CysC、MMP-1、NGAL的表达及临床意义 |
| Expression and Clinical Significance of Serum Hcy, CysC, MMP-1 and NGAL in Patients with Acute Myocardial Infarction after PCI |
| 投稿时间：2021-03-08 修订日期：2021-03-31 |
| DOI：10.13241/j.cnki.pmb.2021.18.027 |
| 中文关键词: 急性心肌梗死 经皮冠脉介入术 心室重构 Hcy CysC MMP-1 NGAL |
| 英文关键词: Acute myocardial infarction Percutaneous coronary intervention Ventricular remodeling Hcy CysC MMP-1 NGAL |
| 基金项目:河北省卫计委重点科技研究计划项目（20190557） |
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| 中文摘要: |
| 摘要 目的：观察急性心肌梗死（AMI）患者经皮冠脉介入术（PCI）术后心室重构患者血清同型半胱氨酸（Hcy）、胱抑素C（CysC）、基质金属蛋白酶-1（MMP-1）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的表达及临床意义。方法：选取2018年3月~2020年9月期间我院收治的AMI患者70例。根据PCI术后是否发生心室重构将其分为无心室重构组（n=49）和心室重构组（n=21）。检测患者血清MMP-1、Hcy、NGAL、CysC水平及心功能指标[左室后壁厚度( LVPWT)、左室舒张末期内径( LVEDD)、左室射血分数( LVEF)、室间隔厚度( IVST)]。分析血清MMP-1、Hcy、NGAL、CysC水平与心功能指标的相关性。分析AMI患者PCI术后心室重构的影响因素。结果：心室重构组血清MMP-1、Hcy、NGAL、CysC水平均高于无心室重构组（P<0.05）；LVEDD、IVST、 LVPWT均大于无心室重构组，LVEF低于无心室重构组（P<0.05）。Pearson相关性分析结果显示：血清MMP-1、Hcy、NGAL、CysC水平和LVEDD、IVST、 LVPWT均呈正相关，而与LVEF呈负相关（P<0.05）。单因素分析结果显示：两组患者梗死部位、心律失常情况、单核细胞（MO）、肌酸激酶同功酶（CK-MB）、发病到开通梗死相关动脉时间组间对比差异均有统计学意义（P<0.05）。多因素Logistic回归分析结果显示：梗死部位为前壁、发生心律失常以及高水平的MO、CK-MB、MMP-1、Hcy、CysC均是AMI患者PCI术后发生心室重构的危险因素（P<0.05）。结论：血清MMP-1、Hcy、NGAL、CysC表达均与AMI患者PCI术后的心室重构密切相关，检测以上指标水平可对AMI患者PCI术后心室重构的预测和防治提供一定参考。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the expression and clinical significance of serum homocysteine (Hcy), Cystatin C (CysC), matrix metalloproteinase-1 (MMP-1), neutrophil gelatinase related lipid delivery protein (NGAL) in patients with acute myocardial infarction (AMI) after PCI. Methods: 70 patients with AMI in our hospital were selected from March 2018 to September 2020. According to whether ventricular remodeling occurred after PCI, they were divided into no ventricular remodeling group(n=49) and ventricular remodeling group (n=21). The serum MMP-1, Hcy, NGAL, CysC levels and cardiac function indexes [left ventricular posterior wall thickness (LVPWT), left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction(LVEF), ventricular septal thickness (IVST)] of patients were detected. The correlation between serum MMP-1, Hcy, NGAL and CysC levels and cardiac function indexes were analyzed. The influencing factors of ventricular remodeling after PCI in patients with AMI were analyzed. Results: The serum MMP-1, Hcy, NGAL and CysC levels in the ventricular remodeling group were higher than those in the no ventricular remodeling group（P<0.05）, while LVEDD, IVST and LVPWT were all greater than those in the no ventricular remodeling group, and LVEF was smaller than that in the no ventricular remodeling group(P<0.05). Pearson correlation analysis results showed that serum MMP-1, Hcy, NGAL, CysC levels were positively correlated with LVEDD, IVST and LVPWT, but negatively correlated with LVEF(P<0.05). Univariate analysis showed that there were statistically significant differences in infarct site, arrhythmia, monocyte (MO), creatine kinase isoenzyme (CK-MB), and time from onset to opening of infarct-related artery between the two groups(P<0.05). Multivariate Logistic regression analysis showed that anterior wall infarction site, arrhythmia occurs and high levels of MO, CK-MB, MMP-1, Hcy and CysC were all risk factors for ventricular remodeling after PCI in patients with AMI(P<0.05). Conclusion: The serum expressions of MMP-1, Hcy, NGAL and CysC are closely related to ventricular remodeling in patients with AMI after PCI. The detection of the above indexes can provide some reference for the prediction and prevention of ventricular remodeling in patients with AMI after PCI. |
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