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Title:: Relation of cardiac collagen remodeling and heart function in patients with acute myocardial infarction

作者:: 彭林林¹; 吴强¹; 张晓丽¹; 俞杉¹; 梁勤¹; 黄山²; 令狐颖²; 1. 贵州省人民医院心内科，2. 贵州省临床检验中心，贵州贵阳 550000

Author(s):: PENG Lin-lin¹; WU Qiang¹; ZHANG Xiao-Li¹; YU Sha¹; LIANG Qin¹; HUANG Shan²; LING Hu-Ying²; 1.Department of Cardiology, Guizhou Provincial People′s Hospital, 2.Guizhou Provincial Centre for Clinical Laboratory, Guiyang 550002, Guizhou, China

关键词:: 心肌梗死; 急性; 胶原; 重构; 心功能

Keywords:: myocardial infarction; actue ; collagen ; remodeling; heart function

分类号:: R541.4

DOI:: -

文献标识码:: A

摘要:: 目的观察急性心肌梗死（AMI）患者血清Ⅰ型前胶原羧基端肽（PⅠ CP）和Ⅲ型前胶原（PCⅢ）水平，探讨AMI后心脏胶原代谢与左室重构及心功能的变化规律。方法应用酶联免疫法检测AMI患者发病后1周和3月的血清PⅠ CP和PCⅢ含量，超声心动图同期检测左室舒张末期内径（LVEDD）、左室舒张末期容积（LVEDV）、左室射血分数（LVEF）和二尖瓣血流舒张早期流速(VE)与心房收缩期流速(VA)的比值。结果 AMI后3月患者血清PⅠ CP和发病后各时点血清PCⅢ均高于对照组，而AMI后3月患者PⅠ CP高于AMI后1周。与正常对照组比较，AMI后各时点的LVEDD 、LVEDV均增高，而LVEF和VE/VA比值降低。AMI发病后1周和3月PCⅢ分别与LVEDD和LVEDV呈正相关，与LVEF呈负相关；AMI发病后1周PⅠ CP分别与LVEDD和LVEDV呈正相关，AMI发病后3月PⅠ CP与LVEF呈负相关。结论 AMI患者心脏胶原代谢活跃，血清PⅠ CP和PCⅢ含量明显持续升高，参与左室重构，与AMI后心功能不全密切相关。

Abstract:: AIM To observe the level of serum concentrations of the carboxyterminal propeptide of procollagen type I(PⅠ CP) and precollagen Ⅲ type(PCⅢ) and to investigate the changes of collagen metabolism, left ventricle remodeling and heart function after acute myocardial infarction (AMI). METHODS The serum concentrations of PⅠ CP and PCⅢ in the patients with AMI were measured by euzymelinked immunosorbent assay at the 1st week and the 3rd months after AMI. All the patients were examined by echocardiography to determine the left ventricular end diastolic diameter (LVEDD), left ventricular end diastolic volume (LVEDV), left ventricular ejection fraction (LVEF) and the VE /VA ratio on synchronic points of time. RESULTS Compared to those in the control group, the serum concentrations of PⅠ CP at the 3rd months and PCⅢ at the 1st week and the 3rd months in AMI group were increased. Compared to those at the 1st week, the serum concentrations of PⅠ CP were increased at the 3th months. The LVEDD and LVEDV increased at the 1st week and the 3rd months after AMI while the LVEF and E/A ratio were lower in comparison with those in the control group. There was a positive correlation between the serum concentration of PCⅢ and LVEDD, LVEDV, while a negative correlation between PCⅢ and the LVEF at the 1st week and the 3rd months after AMI. There was a positive correlation between PⅠ CP and LVEDD, LVEDV at the 1st week but a negative correlation between PⅠ CP and LVEF at the 3rd months after AMI. CONCLUSION The collagen metabolism of heart is activated after AMI. The serum concentrations of PICP and PCⅢ increase and elevate till the 3rd months after AMI, which may cause cardial collagen remodeling and left ventricular remodeling. There is a close relation between the cardial insufficiency and the cardial collagen remodeling .

参考文献/References

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急性心肌梗死患者心脏胶原代谢和左室重构与心功能的关系(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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