冠心病心功能不全患者PCⅢ、LN、HA变化及对比探究.docVIP

冠心病心功能不全患者PCⅢ、LN、HA变化及对比探究 　【关键词】 冠状动脉粥样硬化性心脏病;,,心功能不全;,,前胶原;,,层粘连 　　摘要：目的：：探讨冠心病病人心功能不全改善前后血清Ⅲ型前胶原（PCⅢ）、层粘连蛋白（LN）、透明质酸（HA）的含量变化及其临床意义。方法：将78例冠心病病人分为观察组和对照组, 观察组行冠状动脉造影及左心室造影和超声心动图检查，并测定左室功能，术后每天用异舒吉20mg, 共用14d，治疗结束后再次行超声心动图检查测定左心室功能。两组病人于治疗前后分别测定血清PCⅢ、LN、HA的浓度变化。结果：观察组病人的血清PCⅢ、LN、HA浓度较对照组明显增加(t=14.17～16.69,Plt;0.01)，观察组病人治疗后血清PCⅢ、LN、HA浓度较治疗前明显下降(t=2.352～4.271,Plt;0.05,0.01)。结论：血清PCⅢ、LN、HA在冠心病心功能不全的发生、发展中起重要的作用, 具有一定的临床参考价值。 　　关键词：冠状动脉粥样硬化性心脏病; 心功能不全; 前胶原; 层粘连蛋白; 透明质酸 　　Changes of PCⅢ、LN、HA Levels Caused by Improved Heart Function in Patients with Coronary Artery Disease 　　Abstract：Objective： To explore the effect and clinical signification of changes in serum procollagen typeⅢ(PCⅢ),laminin(LN)and hyaluronic acid(HA) levels in patients with heart dysfunction. Method： 78 patients with dysfunction were divided into observed group and control group. The observed group undergone coronary angiography (CAG) , left ventricular angiography and echocardiography to observe the function of left v entricular. The postoperative patients were treated with isoket 20 mg iv drip, qd for 14 days. The morning venous blood was collected to determine the PCⅢ、LN、HA in these patients one day after therapy, and the echocardiography were undergone again to observe the function of left ventricular. Result：The observed group compared with controlled group. The PCⅢ、LN、HA levels in blood serum increased significantly (t=14.17～16.69,Plt;0.01). The PCⅢ、LN、HA levels observed group after therapy were significantly lower than those before therapy(t=2.352～4.271,Plt;0.05). Conclusion： PCⅢ、LN、HA in blood serum play important roles in occurance and development of coronary heart disease and heart dysfunction. 　　Key words： Coronary artery disease; Ventricular dysfunction; Procollagen; Laminin; Hyaluronic acid 冠心病心肌硬化即心肌纤维化，是由于心肌长期供血不足，心肌发生代谢障碍或萎缩，以致纤维组织增生所致，其特点是心脏逐渐扩大，发生心律失常和心力衰竭。研究表明,在冠心病心功能不全发生的过程中心肌细胞的纤维变性可能起着重要的作用［1，2］，但在心肌纤维变性过程中，除胶原成分外非胶原性糖蛋白及蛋白多糖等细胞外基质成分也在细胞内聚集。本文通过观察冠心病心功能不全患者心功能不全改善前后血清Ⅲ型前胶原（PCⅢ