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血清炎症因子与急性 ST 段抬高型心肌梗死患者左心室重构的相关性研究。

Correlations between serum inflammation factors and left ventricular remodeling in acute ST segment elevation myocardial infarction.

机构信息

Department of Cardiology, Xuanwu Hospital, Capital Medical University, NO 45 Changchun Ave, Xuanwu district, Beijing 100053, PR China.

出版信息

Yonsei Med J. 2012 May;53(3):501-7. doi: 10.3349/ymj.2012.53.3.501.

Abstract

PURPOSE

To investigate the changes and correlations of the serum inflammation factors levels and left ventricular (LV) structure and function in patients with acute ST segment elevation myocardial infarction (STEMI).

MATERIALS AND METHODS

A prospective study was performed on 70 STEMI patients and 70 control subjects. Serum levels of interleukin-6 (IL-6), soluble CD40 ligand (sCD40L), metalloproteinase- 9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were measured by sandwich enzyme-linked immunosorbent assay (ELISA), and cardiac structure and function were assessed by echocardiography at admission and 3-year follow-up.

RESULTS

We found that the levels of serum IL-6, sCD40L and MMP-9 increased steadily among control subjects, remote myocardial infarction and acute STEMI patients, and the level of TIMP-1 elevated remarkly at 3-year follow-up visit in STEMI. The admission level of serum MMP-9 positively correlated with LV end-diastolic and end-diastole volume (r=0.294, p=0.022; r=0.269, p=0.036, respectively), and TIMP-1 positively correlated with E/A ratio (r=0.278, p=0.044) at 3-year follow-up.

CONCLUSION

The study indicates that admission levels of serum MMP-9 and TIMP-1 closely correlated with left ventricular structure and function, which may be involved in the process of post-infarction remodeling of myocardium.

摘要

目的

研究急性 ST 段抬高型心肌梗死(STEMI)患者血清炎症因子水平的变化及其与左心室(LV)结构和功能的相关性。

材料和方法

对 70 例 STEMI 患者和 70 例对照者进行前瞻性研究。采用夹心酶联免疫吸附试验(ELISA)检测血清白细胞介素-6(IL-6)、可溶性 CD40 配体(sCD40L)、基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶组织抑制剂-1(TIMP-1)水平,入院时和 3 年后通过超声心动图评估心脏结构和功能。

结果

我们发现,在对照组、陈旧性心肌梗死和急性 STEMI 患者中,血清 IL-6、sCD40L 和 MMP-9 水平持续升高,而 TIMP-1 水平在 STEMI 患者 3 年随访时显著升高。入院时血清 MMP-9 水平与 LV 舒张末期和舒张末期容积呈正相关(r=0.294,p=0.022;r=0.269,p=0.036),而 TIMP-1 水平与 3 年后随访时的 E/A 比值呈正相关(r=0.278,p=0.044)。

结论

本研究表明,入院时血清 MMP-9 和 TIMP-1 水平与左心室结构和功能密切相关,可能参与心肌梗死后的重构过程。

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