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|本期目录/Table of Contents|

急性ST段抬高型心肌梗死患者高血栓负荷的相关因素(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第4期
页码:
480
栏目:
临床研究
出版日期:
2011-08-25

文章信息/Info

Title:
Related factors for high thrombosis burden of ST-segment elevation myocardial infarction
作者:
刘志; 华琦; 李东宝; 李静; 王艳玲
首都医科大学宣武医院心脏科，北京 100053
Author(s):
LIU Zhi;  HUA Qi;  LI Dong-bao;  WANG Yan-ing
Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China, 100053
关键词:
心肌梗死; 急性; 血栓负荷; 炎症因子
Keywords:
acute myocardial infarction;  thrombus burden;  inflammatory factors
分类号:
R541.4
DOI:
61-1268/R.20110503.1521.015
文献标识码:
A
摘要:
目的:分析在ST段抬高型心肌梗死(ST-segment elevation myocardial infarction，STEMI)患者的急性期，梗死相关血管内血栓高负荷的相关因素。方法: 195例发病时间在12 h以内行急诊经皮冠脉介入(PCI)术的STEMI患者，根据冠脉造影结果分为高血栓负荷组(n=84)和低血栓负荷组(n=111)。受试患者入院急查高敏C反应蛋白(high-sensitivity C-reactive protein，hs-CRP)，白介素-6(interleukin-6,IL-6),可溶性细胞内黏附分子1(soluble intercellular cell adhesion molecule-1,sICAM-1)，P选择素(p selectin，PS)和白细胞(white blood cell，WBC)计数。结果: 高血栓负荷组PS、CK-MB峰值和WBC水平显著高于低血栓负荷组［(14±8) μg/L vs. (8±4) μg/L;(42±52) μg/L vs. (34±39) μg/L;(11±4)×109/L vs. (10±3)×109/L，均P<0.05)。Logistic 回归分析PS(OR=1.259,95%CI 1.125-1.408,P<0.01)是血栓负荷独立的相关因素。结论： PS是STEMI患者闭塞血管高血栓负荷的独立相关指标。
Abstract:
AIM:To explore circulating markers predictive of angiographic morphologic features indicating burden of thrombus formation in infarct-related arteries (IRA) in the acute phase of ST-segment elevation myocardial infarction (STEMI). METHODS: One hundred and ninety-five consecutive acute myocardial infarction (AMI) patients treated with primary percutaneous coronary intervention (PCI) within 12 h of symptom onset were divided into two groups by cineangiography results obtained during PCI: high-burden thrombus formation (HBTF) group (n=84) and low-burden thrombus formation (LBTF) group (n=111). Blood samples were collected before PCI for measurement of circulating levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), soluble intercellular cell adhesion molecule-1 (sICAM-1), p selectin (PS) and white blood cell (WBC) count. RESULTS: The circulating levels of PS and WBC were substantially higher in HBTF patients than those in LBTF patients (13.62±8.13 vs. 7.80±4.17; 11.24±3.62 vs. 10.00±3.35, each P<0.05). Using logistic regression analysis, PS (OR 1.259, 95% CI 1.125-1.408, P=0.000) was an independent predictor of thrombus formation. CONCLUSION: PS level is an independent predictor of angiographic morphological features that indicate high-burden thrombus formation in AMI.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2011-01-07.通讯作者：华琦，教授，主要从事高血压和冠心病研究Email:huaqi5371@medmail.com.cn 作者简介：刘志，博士生Email:liuzhi7742@sina.com
更新日期/Last Update: 2011-06-02