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目的 观察溶栓与非溶栓治疗对老年急性心肌梗死 (AMI)患者血清Ⅲ型前胶原水平及左心功能的影响。 方法 将 38例AMI患者分为静脉溶栓组 (2 1例 )和非溶栓组 (17例 ) ,应用放射免疫法测定血清Ⅲ型前胶原末端肽 (PⅢP)含量 ,采用彩色Doppler超声心动图仪测量左室结构及舒缩功能参数。 结果 溶栓组患者在溶栓开始后 1、2、4、6周血清PⅢP含量分别为 (94 35± 11 32 )、(92 2 6± 10 18)、(89 2 4± 8 92 )和 (86 44± 7 98) μg/L ,较同期非溶栓组患者PⅢP(12 4 30± 9 77)、(12 7 6 0± 11 87)、(10 9 80± 10 96 )和 (96 2 0± 9 17) μg/L明显降低 (P <0 0 5或P <0 0 1) ;溶栓未再通组血清PⅢP含量显著高于再通组 (P <0 0 5或P <0 0 1)。血清PⅢP含量与左室重塑 (LVRM)程度有良好的相关性 (r=0 375 1,P <0 0 5 ) ,与左室舒缩功能呈负相关 (r =- 0 485 7,P <0 0 5 ;r =- 0 45 6 8,P <0 0 5 )。 结论 早期实施静脉溶栓治疗能降低血清PⅢP水平 ,减少LVRM发生 ,改善左心功能。
Objective To investigate the effect of thrombolytic and non-thrombolytic therapy on serum type Ⅲ procollagen and left ventricular function in elderly patients with acute myocardial infarction (AMI). Methods Thirty-eight patients with AMI were divided into thrombolytic group (21 cases) and non-thrombolytic group (17 cases). The content of serum type Ⅲ procollagen peptide (PⅢP) was determined by radioimmunoassay. Color Doppler echocardiography Measurement of left ventricular structure and systolic and diastolic function parameters. Results The levels of PⅢP at the first, second, fourth and sixth week after thrombolytic therapy were (94 35 ± 11 32), (92 26 ± 10 18), (89 24 ± 8 92) and (86 44 ± 7 98) μg / L, PⅢP (12 4 30 ± 9 77), (12 7 6 0 ± 11 87), (10 9 80 ± 10 96) and (96 20) ± 9 17) μg / L (P <0.05 or P <0.01). The level of serum PⅢP in the non-recanalization group was significantly higher than that in the recanalization group (P <0.05 or P <0.01) ). There was a good correlation between serum PⅢP level and left ventricular remodeling (LVRM) (r = 0 375 1, P 0 05), but negatively correlated with left ventricular systolic and diastolic function (r 0 0 485 7, P < 0 0 5; r = - 0 45 6 8, P <0 0 5). Conclusion Early intravenous thrombolysis can reduce serum P Ⅲ P levels, reduce the occurrence of LVRM and improve left ventricular function.