血清谷氨酰转移酶和可溶性细胞间黏附分子-1与急性心肌梗死经皮冠脉介入术后心肌无复流发生的相关性

目的 探讨血清谷氨酰转移酶（GGT）和可溶性细胞间黏附分子（sICAM）-1与急性心肌梗死（AMI）经皮冠状动脉脉介入（PCI）术后心肌无复流发生的相关性。 方法 选取2017年1月至2019年12月收治的335例经PCI治疗的急性ST段抬高型心肌梗死（STEMI）患者纳入研究，采集患者血液标本，测定血清GGT及sICAM-1水平，根据PCI术中心肌梗死溶栓试验(TIMI)血流分级，将患者分为心肌再灌注组（n = 288）与无复流组(n = 47)，比较两组患者血清检测指标及心功能指标水平。 结果 两组糖尿病、脑钠尿肽前体（proBNP）及肌钙蛋白(cTn) I 水平比较差异显著（P < 0.05， P < 0.01）；无复流组和再灌注组的病变长度及发病至血管再通时间比较差异显著（P < 0.01）；无复流组PCI术后即刻及术后48 h的血清GGT及血清sICAM-1水平均显著高于再灌注组（P < 0.05）；无复流组PCI术后48h的血清GGT及血清sICAM-1水平均显著高于PCI术后即刻水平（P < 0.05）；多因素Logistic回归分析结果显示，GGT、sICAM-1及发病至血管再通时间为影响心肌无复流发生的独立危险因素（P < 0.05）。 结论 血清GGT及sICAM-1与AMII PCI术后心肌无复流有关，其水平升高是心肌无复流发生的危险因素。

Correlation between serum glutamyl transferase and soluble intercellular adhesion molecule-1 and myocardial no-reflow after acute myocardial infarction

AIM To investigate the correlation between serum glutamyl transferase and soluble intercellular adhesion molecule-1 and the absence of myocardial regurgitation after PCI in acute myocardial infarction. METHODS Included in the study were 335 patients with acute ST segment elevation myocardial infarction who were treated by PCI in our hospital From January 2017 to December 2019. Their blood samples were collected and serum GGT and sICAM-1 levels were determined. According to the myocardial infarction thrombolysis test blood flow classification during PCI, the patients were divided into myocardial reperfusion group and non-reflow group, and the serum detection index and cardiac function index of the two groups were compared. RESULTS Among the 335 patients with STEMI, there were 47 cases in myocardial no-reflow group and 288 cases in myocardial reperfusion group. The levels of diabetes, troponin I and brain natriuretic peptide precursor between the two groups were significantly different (P<0.05, P<0.01). The length of lesions and the time from onset to vascular recanalization in reperfusion group were significantly different from those in non-reflow group (P < 0.01). Serum GGT and serum sICAM-1 levels were significantly higher in non-reflow group immediately after PCI and at 48h after reperfusion (P < 0.05). Serum GGT and serum sICAM-1 levels immediately and at 48h after PCI in non-reflow group were significantly higher than those in non-reflow group (P < 0.05). Serum GGT and serum sICAM-1 levels at 48h after PCI in non-reflow group were significantly higher than those immediately after PCI (P < 0.05). Multivariate logistic analysis showed that the time from onset to recanalization, GGT and sICAM-1 were independent risk factors for myocardial no-reflow (P < 0.05). CONCLUSION Serum GGT and sICAM-1 are related to myocardial no-reflow after acute myocardial infarction and their elevated levels may be risk factors for myocardial no-reflow.