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目的:探讨基质细胞衍生因子-1α(Stromal cell-derived factor-1α,SDF-1α)在行直接经皮冠状动脉介入治疗(percuta-neous coronary intervention,PCI)的急性心肌梗死患者近期预后预测中的价值。方法:选择78例行直接PCI的急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者、60例择期行PCI的慢性稳定性心绞痛(stable angina pectoris,SAP)患者以及60例冠状动脉造影正常人群,测定其入院时、PCI或冠状动脉造影术后24、48 h的超敏C反应蛋白(hs-CRP)、SDF-1α水平,并对STEMI患者随访,平均(6.3±1.5)个月主要心血管事件(major adverse cardiac events,MACE)。结果:与SAP组、冠状动脉正常组比较,STEMI组入院即刻、术后24、48 h的hs-CRP水平明显升高(P均<0.05),SDF-1α水平均显著降低(P均<0.05),入院即刻(r=-0.208,P<0.05)、术后24 h(r=-0.341,P<0.05)、48 h(r=-0.384,P<0.05)的SDF-1α、hs-CRP水平呈负相关;STEMI患者中随访期间发生MACE 24例,与无MACE者比较,MACE组空腹血糖、肌酐以及3个时间点的hs-CRP、SDF-1α水平均有显著差异(P<0.05)。结论:SDF-1α可能具有抗炎作用,是急性冠脉事件的保护因素,入院即刻的SDF-1α水平可能对STEMI患者近期心血管事件具有预测价值。
Objective: To investigate the short-term prognosis prediction of Stromal cell-derived factor-1α (SDF-1α) in patients with acute myocardial infarction undergoing percuta-neous coronary intervention (PCI) value. Methods: Seventy-eight patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing direct PCI and 60 patients with stable angina pectoris (SAP) undergoing PCI underwent PCI. Coronary angiography was performed to determine the levels of hs-CRP and SDF-1α at 24 h and 48 h after PCI or coronary angiography at admission. The patients were followed up for an average of 6.3 ± 1.5 ) Months major adverse cardiac events (MACE). Results: Compared with the SAP group and the normal coronary artery group, the hs-CRP levels in STEMI group were significantly increased at 24 h and 48 h after operation (all P <0.05), while the levels of SDF-1α were significantly decreased ), SDF-1α, hs-CRP at 24 h after operation (r = -0.341, P <0.05) and 48 h after r = -0.208 (P <0.05). There was a negative correlation between MACE and serum creatinine level in STEMI patients. There were significant differences in fasting blood glucose and creatinine, hs-CRP and SDF-1α levels in MACE group at 3 time points . Conclusion: SDF-1α may have an anti-inflammatory effect and is a protective factor in acute coronary events. Immediate SDF-1α admission may have predictive value on recent cardiovascular events in patients with STEMI.