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目的 探讨急性心肌梗死(acute myocardial infarction,AMI)患者血清补体水平的变化,并评价其在判断预后方面的价值.方法 选择首发AMI患者(发病时间≤12 h)74例与同期入山东省滕州市中心人民医院进行健康体检的健康人50例作为研究对象,分别设为AMI组与对照组,AMI组在入院后第2d早晨采集空腹静脉血3ml进行血清血糖、血脂、纤维蛋白原等生化指标检测,在发病后24 h取血样3 mL进行血清补体C3、C4、C5b-9及氮末端脑钠肽前体(NT-ProBNP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)检测,在发病后3 d、7 d分别取血样3 mL进行血清C3、C4、C5b-9检测;对照组于健康体检日早晨采集空腹静脉血3 mL进行上述指标检测.通过门诊随访了解AMI患者3个月内主要心脏不良事件的发生情况.结果 AMI组发病24 h、3 d及7 d的血清C3、C4、C5b-9水平均明显高于对照组(P<0.05),呈先升高、后降低的动态变化规律,在发病3 d达至峰值;随访3个月11例发生MACE,MACE组发病3d的血清C3、C4、C5b-9水平明显高于非MACE组(P<0.05);AMI患者血清C3、C4、C5b-9与CK-MB、cTnI水平呈正相关(P<0.05).结论 AMI患者血清补体水平呈先升后降的动态变化过程,与病情的严重程度有密切关系,可作为判断AMI患者近期预后的指标.“,”Objective To explore the change of serum complement of patients with AMI, and evaluate the prognosis value of it on AMI,we inititated the study.Methods A total of 74 cases of patients with AMI(attack time were within 24h)were recruited,and 50 healthy person were selected as the control group.The AMI group collected fasting venous blood 3ml after admission 2d to detect blood glucose,blood lipid,fibrinogen,fasting venous blood 3ml after attacked 24h to detect serum C3,C4,C5b-9,NT-ProBNP,CK-MB and cTnI,and fasting venous blood 3ml after attacked 3d and 7d to detect serum C3,C4,C5b-9.The control group collected fasting venous blood 3ml on the healthy check-up day to detect the indicators the same as the AMI group. Results The levels of serum C3,C4 and C5b-9 of the AMI group attacked 24h,3d and 7d were significant higher than those of the control group(P<0.05),presenting a dynamic change of first rising and then reducing,reaching the highest 3d after attacked;11 cases occured MACE,the levels of serum C3,C4 and C5b-9 of the MACE group attacked 3d were significant higher than those of the non-MACE group (P<0.05).There was a positive correlation between serum C3,C4 and C5b-9 and CK-MB、cTnI of the patients with AMI. Conclusion Serum complement of the patients with AMI are presenting the trend of climbing in the first few days and descending in the later,which may be good prognosis indicators of AMI.