急性心肌梗死后血浆可溶性生长刺激表达基因2蛋白与左心室重构的关系

孔祥权; 王志梅; 高晓飞; 李小波; 朱灏; 葛震

doi:10.12125/j.chj.201809046

急性心肌梗死后血浆可溶性生长刺激表达基因2蛋白与左心室重构的关系

Soluble ST2 levels and left ventricular remodeling in patients with acute myocardial infarction

摘要

摘要:
目的探讨接受急诊经皮冠状动脉介入（percutaneous coronary intervention，PCI)）治疗的急性心肌梗死（acute myocardial infarction，AMI）患者血浆可溶性生长刺激表达基因2（soluble growth stimulation expressed gene 2，sST2）蛋白与左心室结构和功能的关系。
方法入选2017-06-01 ~ 2018-05-31南京市第一医院首次确诊AMI并行急诊PCI治疗患者92例，术后第5天采集患者血标本，根据血清sST2浓度水平将患者分为sST2升高组（sST2≥ 35 ng/mL）和sST2正常组（sST2 < 35 ng/mL），超声心动图评价患者左心室重构和心功能。
结果 AMI患者PCI术后第5天血清sST2浓度升高患者的左心室舒张末内径(1eft ventricular end diastolic diammeter, LVEDD)、左心室舒张末容积(1eft ventricular end diastolic volume，LVEDV)和左心室质量指数(1eft ventricular mass index, LVMI)明显高于sST2 正常患者 (P < 0.01或P < 0.05)，左心室射血分数(1eft ventricular ejection fraction, LVEF)则明显低于sST2 正常组 (P < 0.05)，但两组氨基末端B型脑钠肽前体 (N-terminal pro-brain natriuretic peptide，NT-proBNP)浓度并无统计学差异。sST2和高血压是左室重构的独立预测因素。
结论血浆sST2浓度升高是AMI早期左心室偏心性重构的独立相关因素。

Abstract:
AIM To explore the relationship between soluble growth stimulation expressed gene 2 (sST2) and left ventricular structure and function in patients with acute myocardial infarction (AMI).
METHODS The study included 92 patients with AMI and primary percutaneous coronary intervention (PCI) admitted from June 1st 2017 to May 31st 2018 in the Nanjing First Hospital. Patients were stratified into a H- sST2 (sST2 ≥ 35 ng/mL) and a non- H- sST2 group (sST2 < 35 ng/mL).
RESULTS 5 days after PCI, the patients with more than or equal to 35 ng/mL of sST2 showed higher 1eft ventricular diastolic diammeter, 1eft ventricular end diastolic volume, and 1eft ventricular mass index, and lower 1eft ventricular ejection fraction compared with the control group, which was not found in patients with less than 35 ng/mL of sST2. According to echocardiography results however, the NT-proBNP level did not shown any significant changes. Serum sST2 and hypertension were independent predictors for 1eft ventricular remodeling.
CONCLUSION Increased sST2 concentration in patients with AMI was associated with a greater likelihood of exhibiting concentric 1eft ventricular remodeling.

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