基质细胞衍生因子-1α与急性心肌梗死近期预后关系的研究
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江苏省医学重点人才基金项目(RC2007103)


The short-term prognostic value of stromal cell-derived factor-1α in patients with acute myocardial infarction
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    摘要:

    目的:探讨基质细胞衍生因子-1α(Stromal cell-derived factor-1α,SDF-1α)在行直接经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的急性心肌梗死患者近期预后预测中的价值-方法:选择 78例行直接PCI的急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者-60例择期行PCI的慢性稳定性心绞痛(stable angina pectoris,SAP)患者以及60例冠状动脉造影正常人群,测定其入院时-PCI或冠状动脉造影术后24-48 h的超敏C反应蛋白(hs-CRP)-SDF-1α水平,并对STEMI患者随访,平均(6.3 ± 1.5)个月主要心血管事件(major adverse cardiac events,MACE)-结果:与SAP组-冠状动脉正常组比较,STEMI组入院即刻-术后24-48 h的hs-CRP水平明显升高(P均 < 0.05),SDF-1α水平均显著降低(P均 < 0.05),入院即刻(r = -0.208,P < 0.05)-术后24 h(r = -0.341,P < 0.05)-48 h(r = -0.384,P < 0.05)的SDF-1α-hs-CRP水平呈负相关;STEMI患者中随访期间发生MACE 24例,与无MACE者比较,MACE组空腹血糖-肌酐以及3个时间点的hs-CRP-SDF-1α水平均有显著差异 (P < 0.05)-结论:SDF-1α可能具有抗炎作用,是急性冠脉事件的保护因素,入院即刻的SDF-1α水平可能对STEMI患者近期心血管事件具有预测价值-

    Abstract:

    Objective: To investigate the short-term prognostic value of stromal cell-derived factor-1α(SDF-1α) in patients with acute ST-segment elevation myocardial infarction (STEMI) referred to primary percutaneous coronary intervention(PCI). Methods:Serum levels of high sensitivity C-reactive protein (hs-CRP),SDF-1α were measured at baseline,24 and 48 hours after PCI or coronary angiography(CAG) in 78 patients with STEMI,underwent primary PCI,60 patients with stable angina pectoris(SAP) for PCI and 60 healthy adults confirmed by CAG. Major adverse cardiac events (MACE) were analyzed during(6.3 ± 1.5) months of follow-up in patients with STEMI. Results: Serum levels of hs-CRP in the STEMI group at baseline,24 and 48 hours after operation were significantly higher than those in the SAP group and the healthy group(P < 0.05),while levels of SDF-1α were all significantly lower(P < 0.05). Spearman rank correlation revealed that levels of SDF-1α and hs-CRP at baseline,24 and 48 hours after operation were inversely correlated(r = -0.208,P < 0.05;r = -0.341,P < 0.05;r = -0.384,P < 0.05). MACE took place in 24 patients in STEMI group during follow-up. Compared with those of patients without MACE,fasting glucose(FBG),serum creatintine(Cr) and levels of hs-CRP-SDF-1α at three points in MACE group were statistically significant(P < 0.05). Hs-CRP levels at baseline,24 and 48 hours and SDF-1α levels at baseline were independent predictors of MACE when adjusted by FBG and Cr. Conclusion: SDF-1α is probably a cardioprotective factor with antiinflammatory effect. SDF-1α levels at baseline may have short-term predictive value for MACE after AMI.

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李拥军,蔡星星,马根山,陈 忠,汤成春,冯 毅.基质细胞衍生因子-1α与急性心肌梗死近期预后关系的研究[J].南京医科大学学报(自然科学版),2011,(12):1781-1784

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  • 收稿日期:2011-07-17
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