[1]谷阳 史亚非 张刚 张东营 张清.急性ST段抬高型心肌梗死患者血浆中性粒细胞明胶酶相关脂质运载蛋白水平与梗死后心室重构的相关性研究[J].心血管病学进展,2019,(5):836-840.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.042]
　GU Yang,SHI Yafei,ZHANG Gang,et al.Neutrophil Gelatinase-associated Lipocalin is Associated with Cardiac Remodeling in Patients with ST-segment Elevation Myocardial Infarction[J].Advances in Cardiovascular Diseases,2019,(5):836-840.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.042]
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急性ST段抬高型心肌梗死患者血浆中性粒细胞明胶酶相关脂质运载蛋白水平与梗死后心室重构的相关性研究()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2019年5期
页码:
836-840
栏目:
论著
出版日期:
2019-08-25

文章信息/Info

Title:
Neutrophil Gelatinase-associated Lipocalin is Associated with Cardiac Remodeling in Patients with ST-segment Elevation Myocardial Infarction
作者:
谷阳 史亚非 张刚 张东营 张清
(南京医科大学附属淮安第一医院心内科,江苏 淮安 223300)
Author(s):
GU Yang; SHI Yafei; ZHANG Gang; ZHANG Dongying; ZHANG Qing
(Department of Cardiology, The Affiliated Huaian No.1 Peoples Hospital of Nanjing Medical University, Huai’an 223300, Jiangsu,China)
关键词:
急性ST段抬高型心肌梗死; 中性粒细胞明胶酶相关脂质运载蛋白; 肿瘤坏死因子-α; 心肌梗死后心室重构
Keywords:
ST-segment elevation myocardial infarction;  Neutrophil gelatinase-associated lipocalin; Tumor necrosis factor-; Cardiac remodeling after AMI
DOI:
10.16806/j.cnki.issn.1004-3934.2019.05.042
摘要:
目的 研究急性ST段抬高型心肌梗死（STEMI）患者血浆中性粒细胞明胶酶相关脂质运载蛋白水平（NGAL）与发生梗死后心室重构的相关性。方法 选择2017年10月—2018年10月在本科行急诊经皮冠脉介入术（PCI）的STEMI患者82例，分为心室重构组和对照组。比较心室重构组与对照组术前、术后30 d的NGAL、肿瘤坏死因子-a（TNF-α）水平的差异。比较两组术前、术后30 d的超声心动图相关指标。探讨STEMI患者发生梗死后心室重构的影响因素。行受试者工作特征（ROC）曲线分析，探讨NGAL预测发生梗死后心室重构的最佳界值。结果 术后30 d两组的NGAL水平、TNF-α水平均低于PCI术前，差异有统计学意义（P<0.05），且心室重构组的NGAL水平、TNF-α水平高于对照组（P<0.05）。与PCI术前相比，术后30 d两组的左室舒张末内径α为心肌梗死后发生心室重构的影响因素。ROC曲线提示NGAL预测STEMI患者发生梗死后心室重构的曲线下面积为0.855（P<0.05）。结论 STEMI患者NGAL水平与心室重构的发生具有显著的相关性，提示其可作为评估STEMI患者发生心肌梗死后心室重构的一项评估指标。
Abstract:
Objective To investigate the relationship of neutrophil gelatinase-associated lipocalin (NGAL) and cardiac remodeling in patients with ST-segment elevation myocardial infarction(STEMI). Methods A total of 82 patients with STEMI which treated with emergency percutaneous coronary intervention(PCI)，were selected in the affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from Oct 2017 to Oct 2018. The patients were divided into cardiac remodeling group and control group. The left ventricular end-diastolic diameter(LVEDD), interventricular septal thickness, left ventricular posterior wall thickness and ejection fraction of all patients were measured by echocardiography before and 30 days after PCI. The difference of NGAL and tumor necrosis factor(TNF)-α was compared between the two groups before and 30 days after PCI. Multi-factor logistic regression analysis was used to find the factors of cardiac remodeling after acute myocardial infarction(AMI). Receiver operator characteristic (ROC) curve was used to find the optimal cutoff point for predicting the occurrence of cardiac remodeling after AMI. Results The levels of NGAL and TNF-α decreased significantly in two groups 30 days after PCI compared with those before PCI(P <0.05). The levels of NGAL and TNF-α in cardiac remodeling group were higher than those in control group. Meanwhile,the indexes of LVEDD decreased and left ventricular ejection fraction increased dramatically in two groups 30 days after PCI compared with those before PCI(P <0.05). Multi-factor logistic regression analysis showed NGAL and TNF-α were the major factors for cardiac remodeling after AMI (P<0.05). The area under ROC curve of NGAL predicting cardiac remodeling after AMI was 0.855(P<0.05). Conclusion The NGAL levels in patients with STEMI were associated with cardiac remodeling, suggesting it may be used as a indicator to assess cardiac remodeling after AMI.

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备注/Memo

备注/Memo:
基金项目：南京医科大学科技发展基金（NMUB2018148） 收稿日期：2019-02-19
更新日期/Last Update: 2019-12-25