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目的研究分析血浆凝溶胶蛋白在急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者中的临床表达及意义。方法选择2011年8月—2016年8月本院收治的55例临床确诊为STEMI的患者作为观察组,选择同期55例健康体检者作为对照组。根据观察组主要不良心血管事件(major adverse cardiac events,MACE)发生情况分为MACE组(n=32)和非MACE组(n=22)。根据患者生存情况分为死亡组(n=11)和存活组(n=44)。所有对象均进行血浆凝溶胶蛋白含量检测。计量资料采用t检验,P<0.05为差异有统计学意义。结果观察组第1、3、5、7、9天血浆凝溶胶蛋白水平分别为(60.1±10.3)、(52.6±8.2)、(43.8±11.6)、(36.4±7.8)、(40.2±9.3)mg/L,均显著低于对照组的(300.5±40.7)、(297.6±47.6)、(292.3±48.7)、(313.4±57.8)、(277.3±37.3)mg/L,差异均有统计学意义(均P<0.05)。MACE组在第1、3、5、7、9天血浆凝溶胶蛋白水平分别为(53.2±6.7)、(40.2±7.2)、(30.9±10.1)、(22.5±8.7)、(23.3±7.3)mg/L,均显著低于非MACE组的(70.1±11.1)、(64.3±7.7)、(57.7±13.3)、(55.6±9.1)、(69.8±12.6)mg/L,差异均有统计学意义(均P<0.05)。死亡组在第1、3、5、7、9天血浆凝溶胶蛋白水平分别为(53.2±6.7)、(32.5±8.3)、(22.8±6.1)、(14.1±6.7)、(9.3±6.9)mg/L,均显著低于存活组的(53.2±7.2)、(48.7±7.5)、(40.6±9.3)、(33.5±10.2)、(35.9±11.3)mg/L,差异均有统计学意义(均P<0.05)。结论血浆凝溶胶蛋白水平不但对于STEMI患者病情评定以及预后具有十分重要的意义,还有可能成为STEMI患者促进心肌组织恢复、缓解预后的治疗措施,然而其具体的反应机制以及效果仍然需要进行进一步有效的探究验证。
Objective To study the clinical significance of plasma gelsolin in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods From August 2011 to August 2016, 55 patients with clinically diagnosed STEMI in our hospital were selected as observation group and 55 healthy subjects were selected as control group. The MACE group (n = 32) and non-MACE group (n = 22) were divided according to the incidence of major adverse cardiac events (MACE) in the observation group. Divided into death group (n = 11) and survival group (n = 44) according to patient’s survival. All subjects were tested for plasma gelsolin content. Measurement data using t test, P <0.05 for the difference was statistically significant. Results The plasma levels of gelsolin in the observation group were (60.1 ± 10.3), (52.6 ± 8.2), (43.8 ± 11.6), (36.4 ± 7.8), (40.2 ± 9.3) (300.5 ± 40.7), (297.6 ± 47.6), (292.3 ± 48.7), (313.4 ± 57.8) and (277.3 ± 37.3) mg / L in the control group, the differences were statistically significant (All P <0.05). The plasma levels of gelsolin in MACE group were (53.2 ± 6.7), (40.2 ± 7.2), (30.9 ± 10.1), (22.5 ± 8.7), (23.3 ± 7.3) (70.1 ± 11.1), (64.3 ± 7.7), (57.7 ± 13.3), (55.6 ± 9.1) and (69.8 ± 12.6) mg / L in the non-MACE group, the differences were statistically significant Significance (all P <0.05). Plasma levels of plasma gelsolin in the death group were (53.2 ± 6.7), (32.5 ± 8.3), (22.8 ± 6.1), (14.1 ± 6.7), (9.3 ± 6.9) mg / L were significantly lower than those in the survivors (53.2 ± 7.2, 48.7 ± 7.5, 40.6 ± 9.3, 33.5 ± 10.2, 35.9 ± 11.3 mg / L, respectively) (All P <0.05). Conclusions The plasma level of gelsolin is not only of great significance for the evaluation of the disease and prognosis of patients with STEMI, but also may be a therapeutic measure to promote the recovery of myocardial tissue and relieve the prognosis of patients with STEMI. However, its specific reaction mechanism and effect still need to be further effective Proof of inquiry.