脂蛋白a与急性心肌梗死梗死相关动脉自发再通相关性研究.docVIP

脂蛋白a与急性心肌梗死梗死相关动脉自发再通相关性研究 　　摘要：目的探讨脂蛋白a [Lp(a)]与急性ST段抬高型心肌梗死(STEMI)患者梗死相关动脉(IRA)自发再通(SR)的相关性。方法连续观察118例直接行急诊经皮冠状动脉介入治疗的STEMI患者，根据梗死相关动脉造影结果分为自发再通组(前向血流TIMI 2～3级,n=26)和闭塞组(前向血流TIM1 0～1级,n=92)，所有病例均采取静脉血5 mL，进行血生化检查，从中获得血清Lp(a)数值，然后将所得结果进行统计学分析。结果闭塞组Lp(a)水平明显高于自发再通组（237±150）mg/L VS 148±96）mg/L，差异有统计学意义(P0.01)。结论血清Lp(a)水平可以作为STEMI患者梗死相关动脉(IRA)早期自发再通的一个预测指标。 　　关键词：ST段抬高型心肌梗死；自发再通；经皮冠状动脉介入治疗 　　Study on the Relationship between Lipoprotein(a) and Spontaneous Recanalization of Infarct-related Arteries of Acute Myocardial Infarction 　　SHAO Xu-wu,WANG Yue-song,ZHANG Xian-lin,DONG Xue-bin,WANG Xue-zhong,ZHANG Ping 　　(Department of Cardiology, Maanshan Municipal Peoples Hospital,Masnshan 243000,Anhui,China) 　　Abstract：0bjective To explore the relationship between spontaneous recanalization of infarct-related arteries in patients with ST-segment elevation myocardial infarction(STEMI) and plasma level of lipoprotein Lp(a). MethodsA total of 118 patients with STEMI whose blood were obtained at the admission and Lp(a) was measured. Subjects were divided into 2 groups according to the thrombolysis in myocardial infaction (TIMI) grade, Spontaneous recanalization （SR）group(TIMI 2-3, n = 26) versus Persistent occlusion group (TIMI 0-1, n = 92). ResultsThe Lp(a) level was higher in Persistent occlusion group than in SR group（237±150mg/L VS 148±96 mg/L）（P0.01）. Conclusion Plasma level of Lp(a) appeared to be a predictor for patients with spontaneous recanalization of infarct-related arteries in the early phase of STEMI． 　　Key words：ST-segment elevation myocardial infarction；Spontaneous recanalization；Percutaneous coronary intervention 　　 　　脂蛋白a[Lp(a)]是中一种特殊的血浆脂蛋白，因与纤溶酶原具有高度同源性，结构相似，可与纤维蛋白上的纤溶酶原受体竞争结合，抑制纤溶酶原激活，可减弱血栓中纤维蛋白的降解；同时竞争性地抑制了纤维蛋白、纤维蛋白原???其降解产物的纤溶酶原受体，从而促进血栓形成[1]。而急性ST段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）通常是因为冠脉不稳定斑块破裂、糜烂基础上继发血栓形成导致冠状动脉血管持续、完全闭塞[2]。那么Lp(a)是否会影响STEMI梗死相关动脉（infarct-related arteries，IRA)自发再通(spontaneous recanalization SR)呢？目前关于二者的关系的研究