急性心肌梗死后早期血浆心肌纤维化相关指标的变化

目的:观察急性心肌梗死早期内源性松弛素(H2RLX)和Ⅰ型前胶原C端末端肽（PICP）、 转化生长因子（TGF-β1）的的表达。方法:入选41名急性心肌梗死患者和冠脉血管正常的对照组10名。心肌梗死后 3 d、7 d分别抽静脉血，用ELISA方法检测H2RLX和PICP、 TGF-β1，对照组在入选后抽静脉血检测H2RLX和PICP、 TGF-β1。结果:(1)心肌梗死后3 d H2RLX与对照组比较，没有显著差异。梗死后3 d和7 d的H2RLX水平没有明显变化。(2) 梗死后3 d PICP 水平显著高于对照组, PICP在梗死后7 d的水平显著低于梗死后3 d的水平。(3) 梗死后3 d TGF-β1与梗死后7 d TGF-β1保持在较高水平，两个时点的TGF-β1水平均明显高于对照组。(4) 梗死后7 d松弛素水平和心肌梗死组的空腹血糖呈正相关。结论:在心肌梗死早期血浆中没有内源性松弛素表达的增加，但心肌胶原形成及前纤维化因子表达增加。

Early-phase changes of parameters related to myocardial fibrosis in acute myocardial infarction

AIM:To investigate the changes in parameters related to myocardial fibrosis of H2 relaxin (H2RLX) and procollagen type I C-terminal peptide (PICP), transforming growth factor-β1 (TGF-β1) level in the plasma after acute anterior myocardial infarction.METHODS:Forty-one patients with anterior myocardial infarction (MI) and 10 controls with normal coronary vessels were selected.Plasma H2RLX, PICP, and TGF-β1 levels were determined by enzyme linked immunosorbent assay (ELISA) in 10 control subjects and 41 post-MI patients at day 3 and 7 post-MI.RESULTS:(1) H2RLX level at day 3 post-infarct had no difference between the patients and the controls.No marked change in H2RLX at day 3 versus day 7 post-infarct was observed.（2）The level of PICP at day 3 post-infarct was markedly increased followed by a fall at day 7 post-infarct, but was still higher than that in control.(3) TGF-β1 level, which was similar at day 3 and 7 post-infarct, was higher than that in control.(4) At day 7 post-infarct, the level of H2RLX was positively correlated with the fasting blood glucose in MI group.CONCLUSION:In early period of acute MI, profibrotic factors such as TGF-β1 expression and collagen expression increase.However, antifibrotic relaxin has no change.