急诊与择期血运重建对急性心肌梗死后心脏胶原重塑的影响

目的评价急诊与择期血运重建对急性心肌梗死（AMI）后心脏胶原重塑的影响差异。方法45例AMI患者依据不同干预方法分为择期血运重建组（急诊组，25例）和急诊血运重建组（择期组，20例），采用酶联免疫法测定患者在AMI发病后1周、3个月及6个月时的血清Ⅰ型前胶原羧基端肽（PICP）、Ⅲ型前胶原（PCⅢ）。结果急诊组3个月和6个月的PⅠCP及1周时点的PCⅢ浓度分别为（7．61±4．05）ng／ml、（10．44±4．36）ng／ml和（27．91±8．71）ng／ml，均低于择期组的（10．79±4．17）ng／ml、（13．20±4．42）ng／ml和（37．71±13．64）ng／ml，均P〈0．05。结论急诊血运重建对AMI后半年内心脏胶原合成代谢的抑制作用强于择期血运重建。

Effect of emergency and selecetive revascularization on cardiac collagen remodeling after acute myocardial infarction

Objective To observe the effect of emergency and selecetive revascularization on heart collagen remodeling after acute myocardial infarction. Methods According to the different therapies,45 patients with acute myocardial infarction（AMI） were divided into 2 groups： selecetive revascularization group （n=25） and emergency revascularization group（n=20）. The serum concentration of P Ⅰ CP and PC Ⅲ were measured by Elisa on the 1 th week,3th and 6th months after AMI. Results The contents of P Ⅰ CP on 3th and 6th months and PC Ⅲ of lth week in patients of the emergency group were （7.61±4.05）ng/ml, （10.44±4.36）ng/ml and （27.91±8.71）ng/ml respectively. The three items were singnifiantly lower than those in the selective group which P Ⅰ CP were （10.79±4.17） ng/ml, （13.20±4.42）ng/ml and PC Ⅲ were （37.71±13.64）ng/ml （P〈0.05）. Conclusion Effect of emergency revascularization on cardiac collagen remodeling may be superior to the selecetive revascularization in haft-year.