急性心肌梗死患者血浆胸腺素β4水平动态变化的临床意义

发布时间：2018-05-29 02:23

本文选题：心肌梗死 + 胸腺素　；参考：《中国循环杂志》2017年01期

【摘要】：目的:观察急性心肌梗死(AMI)患者在干预治疗下发病后15天内血浆胸腺素β4(Tβ4)水平动态变化趋势,探讨AMI患者血浆Tβ4水平与其临床预后的关系。方法:入选69例AMI患者作为实验组,另入选33例胸痛但经冠状动脉造影术(CAG)排除冠状动脉狭窄的患者为对照组。收集所有受试者入院时及实验组发病15天内每天的静脉血液,检测血浆Tβ4水平。对69例AMI患者进行为期18个月的临床随访,随访终点为主要不良心脏事件(MACE)。结果:(1)与对照组比较,实验组患者入院时及发病第15天血浆Tβ4水平明显升高,差异有统计学意义(P0.01)。(2)实验组患者在干预治疗下血浆Tβ4水平在发病后升高。发病1天后开始下降,在发病第3天达到低值后再次上升,在发病第6天达到高峰,随后逐渐下降,但在发病第11天出现小幅度上升现象。(3)随访期内无MACE发生的AMI患者其住院期间血浆Tβ4峰值较有MACE发生的患者明显升高,差异有统计学意义(P0.01);Logistic回归分析显示:患者住院期间血浆Tβ4峰值与患者在随访期内是否发生MACE显著相关(比值比=0.999,95%可信区间:0.999~1.000)。结论:AMI可诱导机体上调Tβ4的表达;在干预治疗下,AMI患者发病初期血浆Tβ4水平呈现"升-降-升-降"趋势;AMI患者体内Tβ4高表达有助于改善其临床预后,为外源性使用Tβ4治疗AMI提供理论基础。
[Abstract]:Objective: to observe the dynamic change trend of plasma thymosin 尾 4 (T 尾 4) level in patients with acute myocardial infarction (AMI) 15 days after intervention treatment, and to explore the relationship between plasma T 尾 4 level and clinical prognosis in patients with acute myocardial infarction (AMI). Methods: 69 patients with AMI were selected as experimental group and 33 patients with chest pain who were excluded from coronary artery stenosis by coronary angiography. Venous blood samples were collected from all subjects at admission and 15 days after the onset of the disease, and plasma T 尾 4 levels were measured. 69 patients with AMI were followed up for 18 months. Results compared with the control group, the plasma T 尾 4 level in the experimental group was significantly higher than that in the control group at admission and on the 15th day after the onset of the disease, and the difference was statistically significant (P 0.01. 01. 2) the plasma T 尾 4 level in the experimental group was higher than that in the control group. It began to decrease 1 day after onset, rose again on the third day after onset, peaked on the sixth day of onset, and then gradually decreased. However, there was a small increase in plasma T 尾 4 levels in patients with AMI without MACE during the follow-up period. The peak value of plasma T 尾 4 in patients with MACE was significantly higher than that in patients with MACE. Logistic regression analysis showed that the peak value of plasma T 尾 4 during hospitalization was significantly correlated with the occurrence of MACE in the follow-up period (the ratio was 0.99995% CI: 0.999 / 1.000). Conclusion the high expression of T 尾 4 in patients with AMI may improve the clinical prognosis of patients with AMI, and the high expression of T 尾 4 in patients with AMI may be helpful to improve the clinical prognosis of patients with AMI in the early stage of intervention, and the high expression of T 尾 4 in patients with AMI has the trend of "ascending-descending-descending". To provide a theoretical basis for the exogenous use of T 尾 4 in the treatment of AMI.
【作者单位】：安徽医科大学附属安庆医院心内科;皖南医学院弋矶山医院心内科;浙江大学医学院附属第二医院心内科;
【分类号】：R542.22

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