再灌注心律失常对急性心肌梗死患者心肌细胞凋亡及心功能的影响

目的:探讨急性心肌梗死(AMI)患者再灌注心律失常(RA)对心肌细胞凋亡和心功能影响。方法:122例经急诊再灌注治疗的AMI患者,依据有无RA分为RA组(n=43)及无RA组(Non-RA组,n=79)。应用ELISA方法检测再灌注治疗成功后7天及4周血清细胞凋亡信号分子Fas/APO-1水平,1年后随访患者心功能。结果:两组患者性别、年龄、梗死部位、入院时心功能Killip分级无显著差异。(1)再灌注治疗成功后7天RA组血清Fas/APO-1浓度与Non-RA组无统计学差异(P>0.05),4周时RA组血清Fas/APO-1浓度明显高于Non-RA组(P<0.01);(2)AMI再灌注治疗成功1年后,RA组心功能NYHA分级高于Non-RA组(P<0.001)。结论:AMI患者早期成功地进行再灌注治疗,但发生RA患者,心肌细胞凋亡重,远期心功能较未发生心律失常患者差。

Effects of Reperfusion Arrhythmia on Myocardial Apoptosis and Cardiac Function in Patients with Acute Myocardial Infarction

To investigate effects of reperfusion arrhythmias(RA)on apoptosis and cardiac function in patients with a- cute myocardial infarction(AMI).Methods:122 patients with AMI who underwent primary percutaneous intervention were divided into RA group(n=43)and non RA group(n=79).According to the presence of RA.Strepavidin-biotin ELISA was used to determine the soluble Fas/APO-1 plasma concentration at 7day and 4week.Cardiac function was evaluated one year later according to the stan- dard of New York Heart Association.Results:There was no difference between two groups in the basic characteristics,such as sex, age,infarction position and Killip cardiac function.(1)The Fas/APO-1 levels were no difference between two groups at 7day(P>0.05),the Fas/APO-1 levels in patients of RA group higher than those of Non-RA group at 7day and 4week(P<0.01).(2)One year later,the cardiac function of patients in RA group was higher than that of Non-RA group(P<0.001).Conclusion:RA was related with cardiomyocytes apoptosis in patients with AMI,and might influence left ventricular function long-term.