sST2参与急性心肌梗死后心肌纤维化
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(兰州大学第一医院心脏中心, 甘肃省兰州市 730000)

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马红利,硕士研究生,主要研究方向为冠心病,E-mail为1073989590@qq.com。

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sST2 participates in myocardial fibrosis after acute myocardial infarction
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Department of Heart Center, the First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China)

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    摘要:

    目的 探索可溶性生长刺激表达基因2(sST2)与急性心肌梗死(AMI)后心肌纤维化的关系。 方法 入选2015年1月至2016年9月入住兰州大学第一医院心脏中心的患者249例,AMI组为首次诊断AMI的166例患者,对照组为冠状动脉造影阴性的83例患者。测定患者血清sST2、Ⅲ型前胶原氨基端肽(PⅢNP)及N末端B型利钠肽原(NT-proBNP)水平,并收集心脏超声中与左心室收缩功能相关的指标:左心室射血分数(LVEF)、左心室收缩期末容积(LVESV)、左心室舒张期末容积(LVEDV),并进行比较、分析。 结果 AMI组血清sST2、PⅢNP、NT-proBNP水平及LVESV、LVEDV值均高于对照组,LVEF值明显低于对照组(P<0.05或P<0.01)。AMI组中,LVEF<50%亚组血清sST2水平高于LVEF≥50%亚组(P=0.031)。AMI组中血清sST2与PⅢNP呈正相关(r=0.181,P=0.02),与LVEF呈负相关(r=-0.179,P=0.021)。AMI组中血清sST2、NT-proBNP及sST2+NT-proBNP诊断AMI后心力衰竭的ROC曲线下面积分别为0.608、0.683和0.732。 结论 血清sST2参与AMI后心肌纤维化过程,并与左心室收缩功能有关。血清sST2水平对AMI后心力衰竭具有诊断价值。

    Abstract:

    Aim To explore the relationship between soluble growth stimulation expressed gene 2 (sST2) and myocardial fibrosis after acute myocardial infarction (AMI). Methods 249 cases were selected from January 2015 to September 2016 in the First Hospital of Lanzhou University, AMI group had 166 cases that were first diagnosed as AMI patients, while 83 cases of coronary angiography negative in the control group. The level of serum sST2, procollagen Ⅲ N-terminal peptide (PIIINP), aminoterminal pro-brain natriuretic peptide (NT-proBNP) were tested and left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) were collected, compared and analyzed. Results Serum sST2, PⅢNP and NT-proBNP levels and values of LVESV and LVEDV in AMI group were higher than those in control group, values of LVEF in AMI group were lower than those in control group (P<0.05 or P<0.01). Serum sST2 level in LVEF<50% subgroup of AMI group was higher than LVEF≥50% subgroup (P=0.031). Serum levels of sST2 were positively correlated with PⅢNP (r=0.181, P=0.02), and negatively correlated with LVEF (r=-0.179, P=0.021) in group AMI. Serum sST2, NT-proBNP and sST2+NT-proBNP in AMI group could diagnose heart failure after AMI, and their areas under ROC curve were 0.8,0.683 and 0.732 respectively. Conclusion Serum sST2 participates in the process of myocardial fibrosis after AMI, and is correlated with left ventricular systolic function. Serum sST2 levels have diagnostic value in heart faliure after AMI.

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马红利,彭瑜,李超,牛镜磊,蒋英志,潘晨亮,张钲. sST2参与急性心肌梗死后心肌纤维化[J].中国动脉硬化杂志,2017,25(7):715~718.

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  • 收稿日期:2016-10-31
  • 最后修改日期:2017-02-18
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  • 在线发布日期: 2017-07-31