老年急性心肌梗死后心肌纤维化的研究

目的　探讨老年急性心肌梗死 (AMI)患者组织纤维化血清学指标的变化及其反映心梗早期心室重构和心肌纤维化的临床意义。方法　以放免法测定老年 AMI再通组 31例 ,未通组 1 6例及正常对照组 2 7例血清中层粘连蛋白 (L N)、 型前胶原 (PC )和透明质酸 (HA)的含量 ;并将左室舒张末期内径 (LVDd)和射血分数 (EF)与上述各参数作相关分析。结果　老年 AMI患者未通组血清 L N、PC 、HA含量较其他两组水平增高显著 ,并与 LVDd呈正相关 ;但其他两组的参数间及其与 EF的关系无统计学意义。结论　血清 LN、PC 、HA均可作为老年 AMI患者心肌组织纤维化的血清学指标 ,在临床上为判断 AMI后早期心室重构和心肌纤维化提供了间接依据。

The clinical significance of serum LN, PC Ⅲ HA in acute myocardial infarction

Objectives To investigate the changes and clinical significance of serum fibrotic indices in elder patients with acute myocardial infarction (AMI).Methods Serum precollagen by radioimmunoassay in 31 AMI patients with successful recanalization, 16 AMI patients with unsuccessful recanalization, and 27 healthy subjects. The correlation between left ventricular end-diastolic diameter (LVDd), ejection fraction and the parameters mentioned above were analyzed.Results Serum LN, PCIII and HA were significantly increased in elderly AMI patients without successful recanalization as compared with other two groups and also positively correlated with LVDd but not with EF. These were not found in other two groups.Conclusions These findings suggest that measurements of LN, PCIII and HA may provide indirect diagnostic information on myocardial fibrosis and ventricular remodeling associated with AMI.