TNF-α与sCD40L在AMI患者PCI术后相关并发症中的临床意义.docVIP

TNF-α与sCD40L在AMI患者PCI术后相关并发症中的临床意义 邢永生 韩明磊 王鹏飞 金卫东 杨树涵 王成 侯永兰 刘艳宾 刘振 崔佳佳 （新乡市中心医院心血管内一科 河南省新乡市 453000 通讯作者：邢永生 Email:xingys@ ） 摘要 目的 通过对比急性心肌梗死（Acute myocardial infarction, AMI）患者血清肿瘤坏死因子α(Tumor necrosis factor-α, TNF-α)与可溶性CD40配体（Soluble cluster of differentiation 40 ligand，sCD40L）术前及术后的浓度变化，探讨其在AMI患者经皮冠状动脉介入治疗( Percutaneous coronary intervention, PCI )术后相关并发症中的作用。方法 采用固相夹心酶联免疫法测定75例AMI患者发病6～12小时内（PCI术前）及术后24小时血浆TNF-α与sCD40L浓度，同时，根据住院期间病情AMI患者分为3组：死亡组、并发症组及无并发症组。结果 1. 死亡组术前血浆TNF-α（206.4±57.58）ng/L与sCD40L（10.29±0.89）mg/L的浓度明显高于并发症组TNF-α（158.03±34.98）ng/L与sCD40L（7.32±1.83）mg/L及无并发症组TNF-α（95.21±24.08）ng/L与sCD40L（5.18±0.41）mg/L，差异均有统计学意义（P0.01），并发症组也明显高于无并发症组，差异也有统计学意义（P0.05）；术后死亡组血浆的浓度明显高于并发症组及无并发症组，差异均有统计学意义（P0.01）；2. 各组本身术前及术后对比死亡组及并发症组术后明显高于术前，差异有统计学意义（P0.05），无并发症术前术后对比，差异无统计学意义（P0.05）。结论 TNF-α与sCD40L与AMI患者PCI术后并发症的发生相关，其术前及术后血清浓度越高，近期发生严重并发症的可能性越大，二者测定可作为判断AMI患者急诊PCI术后近期预后的指标。 关键词　心肌梗死；经皮冠状动脉介入治疗；肿瘤坏死因子α；可溶性CD40配体 中图分类号: R 541.4 文献标识码：A Clinical significance of TNF-αand sCD40L in complication of AMI patients after PCI Xing yong-sheng Han ming-lei Wang peng-fei Jin wei-dong Yang shu-han Wang cheng Hou yong-lan Liu yan-bin Liu zhen Cui jia-jia ( first department of Cardiology, central hospital of Xinxiang city, Henan province, 453000) Abstract Objective To investigate the clinical significance of TNF-αand sCD40L in complication of AMI patients after PCI by compared the changing of pre- and post-operation plasma TNF-αand sCD40L in patients with AMI. Methods Plasmic levels of TNF-α and sCD40L were assaied within the onset 6～12h and post-operation 24h by adopted ELISA in 75 AMI patients. The AMI patients were divided into 3 sub-groups: the death group, the complication group and the no complication group. Results 1. Plasmic level of TNF-α（206.4±57.58）ng/L and sCD40L (10.29±0.89）mg/L of the death group at preoperation was higher than TNF-α(158.03±34.98)ng/L and sCD40L(7.32±1.83)mg/L of the complication group and TNF-α(95.21±24.08)ng/Land sCD40L (5.18±0.41)mg/L