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目的探讨急性心肌梗死患者溶栓治疗前后血管内皮生长因子-A(vascular endothelia growth factor-A,VEGF-A)水平的变化及其临床意义。方法选取溶栓治疗急性心肌梗死患者28例及冠状动脉造影正常对照组25例。采用酶联免疫吸附法测定血浆VEGF-A的水平。结果急性心肌梗死组血浆VEGF-A水平显著高于对照组,溶栓治疗后2h血浆VEGF-A水平显著下降,差异均有统计学意义(P<0.01)。治疗后12h血浆VEGF-A水平仍高于正常对照组,差异有统计学意义(P<0.05)。血管未通组治疗前血浆VEGF-A的水平显著高于血管再通组,差异有统计学意义(P<0.05),治疗后各时间点未通组略高于再通组水平,但差异尚未达到统计学意义(均P>0.05)。结论增高的血浆VEGF-A的水平参与了急性心肌梗死病理过程,VEGF-A的水平是反映心肌缺血的敏感指标,但是尚不能作为有效评价溶栓治疗效果的指标。
Objective To investigate the changes of vascular endothelia growth factor-A (VEGF-A) levels in patients with acute myocardial infarction before and after thrombolysis and their clinical significance. Methods Twenty - eight patients with acute myocardial infarction and 25 normal coronary angiography patients were included in the study. Plasma VEGF-A levels were measured by enzyme-linked immunosorbent assay. Results The plasma level of VEGF-A in acute myocardial infarction group was significantly higher than that in control group. The level of plasma VEGF-A in 2 hours after thrombolysis was significantly lower (P <0.01). Plasma VEGF-A level was still higher 12h after treatment than the normal control group, the difference was statistically significant (P <0.05). The level of plasma VEGF-A before treatment in patients with vascular failure was significantly higher than that in patients with recanalization, the difference was statistically significant (P <0.05). After treatment, the levels of VEGF-A were slightly higher than those of recanalization group Reaching statistical significance (all P> 0.05). Conclusions Increased plasma levels of VEGF-A are involved in the pathogenesis of acute myocardial infarction. The level of VEGF-A is a sensitive indicator of myocardial ischemia, but it can not be used as an effective indicator to evaluate the efficacy of thrombolytic therapy.