心型脂肪酸结合蛋白在心梗患者行介入治疗中的意义.docVIP

心型脂肪酸结合蛋白在心梗患者行介入治疗中的意义 　　【摘要】目的 观察ST段抬高型心肌梗死患者行经皮冠脉介入治疗（PCI）前后心型脂肪酸结合蛋白（H-FABP）变化及意义。方法 选择北京朝阳医院急诊科确诊ST段抬高型心肌梗死患者178例，根据PCI术后ST段回落程度分为两组，即ST段回落组及ST段无回落组，分别为137人及41人。所有病例均于入院即刻测定H-FABP及心肌肌钙蛋白（cTnI），并在PCI术后1 h，6 h，12 h和24 h再分别测定H-FABP质量浓度，PCI术后12 h及24 h测定cTnI。测定PCI术后2 hST段回落幅度（ΣSTR）。结果 ST段回落组及ST段无回落组PCI术前人口统计学资料差异无统计学意义。两组患者术后6 h H-FABP明显高于术前（P0.05），ST段回落组患者于24 h H-FABP恢复至正常水平，而ST段无回落组患者H-FABP未降至正常水平。结论 ST段抬高型心肌梗死患者血清H-FABP升高与冠脉病变程度有关，PCI术可影响H-FABP变化，ΣSTR≥50%与H-FABP降至正常水平以下有利于判断患者的心肌损伤程度和心肌再灌注。 　　【关键词】ST段抬高型心肌梗死；经皮冠状动脉介入治疗；心型脂肪酸结合蛋白；肌钙蛋白；ST段回落幅度；冠脉病变；心肌损伤；心肌再灌注 　　The study of heart-type fatty acid binding protein in the PCI therapy for patients with acute myocardial infarction ZHANG Jian， LI Chun-sheng. Department of Emergency Medicine， Beijing Chao-Yang Hospital， Capital Medical University， Beijing 100020， China 　　Corresponding author： LI Chun-sheng， Email：lcscyyy@ 　　【Abstract】Objective To observe the change and clinical significance of the heart type fatty acid binding protein （H-FABP ） in ST Segment Elevation Myocardial Infarction（STEMI） after percutaneous coronary intervention （PCI）.Methods Of 178 STEMI patients were recruited and were separated as ST segment drop group （137） and ST segment non-drop group （41）. All the patients received H-FABP and cTnI tests， and re-tested H-FABP on 1 h， 6 h， 12 h and 24 h after the PCI， and re-tested cTnI on 12 h and 24 h after the PCI. Also， the ST segment drop amplitude （ΣSTR ） was measured 2 h after the PCI.Results The demographics of both groups were similar. In both groups， the H-FABP on 6 h after PCI was significantly higher than the value measured prior to PCI. In the ST segment drop group， the H-FABP was reduced to normal value on 24 h after PCI， while it was not in the ST segment non-drop group.Conclusions The H-FABP elevation is associated with the severity of coronary lesions in ST segment elevation myocardial infarction， and the PCI may be involved in the H-FABP changes. ΣSTR≥50% and normal H-FABP may be use