AMI患者血清hs-CRP、MMP9、soL-CXCL16、NT-proBNP的变化及其意义
|
摘要
目的探讨急性AMI(AMI)患者血清超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP9)、可溶性趋化因子-16(soL-CXCL16)、N-末端脑钠肽前体(NT-proBNP)的变化及其意义。方法选取我院(2016. 01～2017. 01)收治的140例AMI患者(AMI组)、健康体检对象70例(对照组),检测两组对象的血清hs-CRP、MMP9、soL-CXCL16、NT-proBNP水平,并根据冠脉病变支数、PCI治疗前后进行组内分层分析。结果 AMI组患者的hs-CRP、MMP9、soL-CXCL16、NTproBNP水平均显著的高于对照组,差异有统计学意义(P<0. 05);三支病变的AMI组患者的血清hs-CRP、MMP9、soL-CXCL16、NT-proBNP水平均显著的高于单支病变组和双支病变组,差异有统计学意义(P<0. 05);双支病变患者的血清hsCRP、MMP9、soL-CXCL16显著高于单支患者,差异有统计学意义(P<0. 05); PCI治疗后3天,AMI组患者的血清hs-CRP、MMP9、soL-CXCL16、NT-proBNP水平较术前进一步升高,差异有统计学意义(P <0. 05); PCI术后第7天,AMI患者血清hs-CRP、MMP9、soL-CXCL16、NT-proBNP水平均较术前降低,差异有统计学意义(P <0. 05)。结论 AMI患者hs-CRP、MMP9、soL-CXCL16、NT-proBNP水平较健康人群升高,对于评估病情及PCI手术效果具有一定的临床价值。
Objective To investigate the change and significance of serumhigh-sensitivity C-reactive protein( hs-CRP) 、matrix metalloproteinase-9( MMP9),soluble chemokine-16( soL-CXCL16) and N-terminal pro-Brain natriuretic peptide( NT-proBNP) levels in patients with acute myocardial infarction( AMI). Methods A total of 140 patients with AMI( AMI group) and 70 healthy subjects( control group) administrated in our hospital between January 2016 and January 2017 were enrolled.Serum levels of hs-CRP,MMP9,soL-CXCL16 and NT-proBNPwere measured in the two groups. Further analysis stratified by the number of diseased coronary vessels,pre-and post-treatment of percutaneous coronary intervention( PCI) wasperformedwithin groups. Results The levels of hs-CRP,MMP9,soL-CXCL16 and NT-proBNPof AMI patients were significantly higher than those in the control group( P<0. 05).In the AMI group,stratification analysis showed that the levels of hs-CRP,MMP9,soL-CXCL16 and NT-proBNP in patients with three diseased coronary vessels were significantly higher than those with one or two diseased coronary vessels( P<0. 05).And those with two diseased coronary vessels had higher serum hs-CRP、MMP9、soL-CXCL16 concentration than those with single diseased coronary vessel( P<0. 05).Serum levels of hs-CRP、MMP9、soL-CXCL16、NT-proBNP in AMI patients were increased on the third day( P<0. 05) and decreased on the seventh day( P<0. 05) after PCI treatment compared with the pre-treatment data.Conclusion Serum levels of hs-CRP,MMP9,soL-CXCL16 and NT-proBNP in patients with AMI were significantly higher than those in healthy people,which has certain clinical value for the evaluation of disease severity and the efficacy assessment of PCI therapy.
Objective To investigate the change and significance of serumhigh-sensitivity C-reactive protein( hs-CRP) 、matrix metalloproteinase-9( MMP9),soluble chemokine-16( soL-CXCL16) and N-terminal pro-Brain natriuretic peptide( NT-proBNP) levels in patients with acute myocardial infarction( AMI). Methods A total of 140 patients with AMI( AMI group) and 70 healthy subjects( control group) administrated in our hospital between January 2016 and January 2017 were enrolled.Serum levels of hs-CRP,MMP9,soL-CXCL16 and NT-proBNPwere measured in the two groups. Further analysis stratified by the number of diseased coronary vessels,pre-and post-treatment of percutaneous coronary intervention( PCI) wasperformedwithin groups. Results The levels of hs-CRP,MMP9,soL-CXCL16 and NT-proBNPof AMI patients were significantly higher than those in the control group( P<0. 05).In the AMI group,stratification analysis showed that the levels of hs-CRP,MMP9,soL-CXCL16 and NT-proBNP in patients with three diseased coronary vessels were significantly higher than those with one or two diseased coronary vessels( P<0. 05).And those with two diseased coronary vessels had higher serum hs-CRP、MMP9、soL-CXCL16 concentration than those with single diseased coronary vessel( P<0. 05).Serum levels of hs-CRP、MMP9、soL-CXCL16、NT-proBNP in AMI patients were increased on the third day( P<0. 05) and decreased on the seventh day( P<0. 05) after PCI treatment compared with the pre-treatment data.Conclusion Serum levels of hs-CRP,MMP9,soL-CXCL16 and NT-proBNP in patients with AMI were significantly higher than those in healthy people,which has certain clinical value for the evaluation of disease severity and the efficacy assessment of PCI therapy.
引文
[1]Hansen KW,Hvelplund A,Abildstrφm SZ,et al.Prognosis and treatment in patients admitted with acute myocardial infarction on weekends and weekdays from 1997 to 2009[J].International Journal of Cardiology,2013,168(2):1167-1173.
[2]Stengaard C,Sφrensen JT,Ladefoged SA,et al.Quantitative Pointof-Care Troponin T Measurement for Diagnosis and Prognosis in Patients With a Suspected Acute Myocardial Infarction[J].The American Journal of Cardiology,2013,112(9):1361-1366.
[3]薛剑,蒋静,李军,等.超敏C反应蛋白水平与急性冠脉综合征危险分层的相关性分析[J].标记免疫分析与临床,2015,22(10):956-959.
[4]朱嘉俊,徐锐,杨毅宁,等.金属基质蛋白酶9预测早发急性冠脉综合征患者冠状动脉病变程度的临床研究[J].中国现代医学杂志,2015,25(16):32-36.
[5]詹莉.CXCL16在冠状动脉粥样硬化形成及易损斑块中的作用初探[J].中西医结合心脑血管病杂志,2016,14(10):1140-1143.
[6]赵军,吴立明,王亮,等.N-末端脑钠肽前体用于诊断急性冠脉综合征的临床价值[J].中国煤炭工业医学杂志,2017,20(02):136-139.
[7]Uretsky BF.Pathophysiology and prognosis:The curious case of the periprocedural myocardial infarction[J].Catheterization and Cardiovascular Interventions,2013,81(6):968-969.
[8]García-García C,Molina L,Subirana I,et al.Sex-based Differences in Clinical Features,Management,and 28-day and 7-year Prognosis of First Acute Myocardial Infarction.RESCATE II Study[J].Revista Espanola de Cardiología(English Edition),2014,67(1):28-35.
[9]许苗苗,沈伟,施海明,等.外周血单核细胞亚群及其趋化因子在急性冠脉综合征早期的表达特点[J].复旦学报(医学版),2017,44(04):403-409.
[10]黄桂锋,吴泽彬,李吉林.急性冠脉综合征患者冠状动脉介入治疗围术期可溶性CXC趋化因子配体16的表达规律[J].岭南心血管病杂志,2014,20(05):581-583.
[11]杨震,张军涛.急性冠脉综合征患者血清hs-CRP和NT-proBNP水平变化及临床意义[J].河北联合大学学报:医学版,2013,15(3):351-352.
[12]王薇.血清胱抑素C、超敏C反应蛋白表达水平对急性冠脉综合征的临床诊断价值[J].国际免疫学杂志,2014,37(4):352-355.
[13]孙顺洋,邵雪松,祁正军,等.冠状动脉CTA、超敏C反应蛋白在急性冠脉综合征患者诊断中的应用价值[J].中国循证心血管医学杂志,2015,7(06):836-838.
[14]董晓龙,屈颖聪,周东东,等.冠脉搭桥术患者心外膜、胸腔内脂肪组织中瘦素、基质金属蛋白-9的表达及临床意义[J].山东医药,2016,36(33):39-41.
[15]Ng LL,Sandhu JK,Narayan H,et al.Proenkephalin and Prognosis After Acute Myocardial Infarction[J].Journal of the American College of Cardiology,2014,63(3):280-289.
[2]Stengaard C,Sφrensen JT,Ladefoged SA,et al.Quantitative Pointof-Care Troponin T Measurement for Diagnosis and Prognosis in Patients With a Suspected Acute Myocardial Infarction[J].The American Journal of Cardiology,2013,112(9):1361-1366.
[3]薛剑,蒋静,李军,等.超敏C反应蛋白水平与急性冠脉综合征危险分层的相关性分析[J].标记免疫分析与临床,2015,22(10):956-959.
[4]朱嘉俊,徐锐,杨毅宁,等.金属基质蛋白酶9预测早发急性冠脉综合征患者冠状动脉病变程度的临床研究[J].中国现代医学杂志,2015,25(16):32-36.
[5]詹莉.CXCL16在冠状动脉粥样硬化形成及易损斑块中的作用初探[J].中西医结合心脑血管病杂志,2016,14(10):1140-1143.
[6]赵军,吴立明,王亮,等.N-末端脑钠肽前体用于诊断急性冠脉综合征的临床价值[J].中国煤炭工业医学杂志,2017,20(02):136-139.
[7]Uretsky BF.Pathophysiology and prognosis:The curious case of the periprocedural myocardial infarction[J].Catheterization and Cardiovascular Interventions,2013,81(6):968-969.
[8]García-García C,Molina L,Subirana I,et al.Sex-based Differences in Clinical Features,Management,and 28-day and 7-year Prognosis of First Acute Myocardial Infarction.RESCATE II Study[J].Revista Espanola de Cardiología(English Edition),2014,67(1):28-35.
[9]许苗苗,沈伟,施海明,等.外周血单核细胞亚群及其趋化因子在急性冠脉综合征早期的表达特点[J].复旦学报(医学版),2017,44(04):403-409.
[10]黄桂锋,吴泽彬,李吉林.急性冠脉综合征患者冠状动脉介入治疗围术期可溶性CXC趋化因子配体16的表达规律[J].岭南心血管病杂志,2014,20(05):581-583.
[11]杨震,张军涛.急性冠脉综合征患者血清hs-CRP和NT-proBNP水平变化及临床意义[J].河北联合大学学报:医学版,2013,15(3):351-352.
[12]王薇.血清胱抑素C、超敏C反应蛋白表达水平对急性冠脉综合征的临床诊断价值[J].国际免疫学杂志,2014,37(4):352-355.
[13]孙顺洋,邵雪松,祁正军,等.冠状动脉CTA、超敏C反应蛋白在急性冠脉综合征患者诊断中的应用价值[J].中国循证心血管医学杂志,2015,7(06):836-838.
[14]董晓龙,屈颖聪,周东东,等.冠脉搭桥术患者心外膜、胸腔内脂肪组织中瘦素、基质金属蛋白-9的表达及临床意义[J].山东医药,2016,36(33):39-41.
[15]Ng LL,Sandhu JK,Narayan H,et al.Proenkephalin and Prognosis After Acute Myocardial Infarction[J].Journal of the American College of Cardiology,2014,63(3):280-289.