急性心肌梗死患者经皮冠状动脉介入治疗后尿水通道蛋白-2的变化及意义

目的研究急性心肌梗死经皮冠状动脉介入（percutaneous coronary intervention，PCI）治疗后尿水通道蛋白-2（aquaporin-2，AQP2）的变化，探讨AQP2与心肌细胞水肿的关系。方法选择80例急性心肌梗死患者，分组检验治疗前、后尿AQP2不同时段浓度，同时检测血清肌钙蛋白-I、B型脑钠肽浓度。分析AQP2与肌钙蛋白-I、B型脑钠肽的相关性。结果心肌梗死组尿AQP2浓度明显高于正常对照组，差异有统计学意义（P〈0．05）。早期再灌注治疗能显著降低尿AQP2浓度，差异有统计学意义（P〈0．01）。急诊PCI治疗亚组较尿激酶亚组更能降低尿AQP2浓度，差异有统计学意义（P〈0．05）。心肌梗死后血清肌钙蛋白-I（r=0．89，P〈0．03）、B型脑钠肽浓度（r=0．78，P〈0．05）与AQP2显著正相关。结论急性心肌梗死后尿AQP2浓度明显升高，PCI治疗能显著降低尿AQP2浓度。AQP2与心肌坏死指标和心力衰竭指标相关性高，可能参与急性心肌梗死后心力衰竭的发生、发展。

Change and significance of urinary aquaporin-2 in patients with acute myocardial infarction after percutaneous coronary intervention

Objectives To research the change and significance of urinary aquaporin-2 （AQP2） in patients with acute myocardial infarction after percutaneous coronary intervention （PCI）, and to study the relation between AQP2 and cellular edema. Methods We selected 80 patients with acute myocardial infarction in this study. The patients were divided into different groups and urine concentrations of AQP2 in different periods before and after treatment were tested. Serum concentrations of troponin-I and brain natriuretic peptide （BNP） were also tested. Correlation analysis was carried out on AQP2 ,troponin-I and BNP. Results Urine concentration of AQP2 in patients with acute myocardial infarction was obviously higher than that in control group （P〈0.05）. Urine concentration of AQP2 significantly reduced after early reperfusion treatment （P〈0.01）. Urine concentration of AQP2 reduced much more in PCI subgroup than in urokinase subgroup （P〈0.05）. Serum concentrations of troponin-I （r=0.89, P〈0.03） and BNP （r=0.78, P〈0.05） after acute myocardial infarction had positive relations with AQP2. Conclusions Urine concentration of AQP2 increases in patients with acute myocardial infarction, and it reduces after PCI. AQP2 has a high relation with myocardial necrosis and heart failure index, and it may affect the occurrence and development of acute heart failure after myocardial infarction.