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目的:探讨血运重建对急性心肌梗死(AMI)患者心脏胶原合成和降解代谢的影响。方法:对65例AMI患者分别予以常规强化内科保守治疗(常规治疗组,20例)或在此基础上的血运重建治疗(血运重建组,45例),应用酶联免疫法分别检测AMI后1周、3个月及6个月的血清Ⅰ型前胶原羟基端肽(PⅠCP)、Ⅲ型前胶原(PCⅢ)、基质金属蛋白酶-1(MMP-1)及基质金属蛋白酶组织抑制剂因子-1(TIMP-1)含量,并计算PⅠCP/PCⅢ的比值。以48例正常人为对照组。结果:与对照组比较,常规治疗组各亚组和血运重建组6个月亚组的PⅠCP及常规治疗组和血运重建组各亚组的PCⅢ明显增高(P<0.05),而2组的PⅠCP/PCⅢ、MMP-1及TIMP-1显著降低(P<0.05)。血运重建组各亚组的PⅠCP、1周亚组的PCⅢ及6个月亚组的MMP-1低于常规治疗组相应时点亚组(P<0.05)。结论:AMI后出现心脏胶原重塑的表现。在常规治疗的基础上,血运重建可进一步抑制AMI后心脏胶原的合成与降解。
Objective: To investigate the effects of revascularization on cardiac collagen synthesis and metabolism in patients with acute myocardial infarction (AMI). Methods: Sixty-five patients with AMI were treated by routine intensive internal medicine (conventional treatment group, n = 20) or revascularization therapy (revascularization group, n = 45). AMI Serum procollagen hydroxy terminal peptide (PⅠCP), type Ⅲ procollagen (PCⅢ), matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase (TIMP-1) -1 (TIMP-1) content, and calculate the ratio of P Ⅰ CP / PC Ⅲ. 48 normal subjects as control group. Results: Compared with the control group, the PCⅢ of the PⅠCP group and the subgroup of the routine revascularization group and the routine revascularization group in the 6-month subgroups in routine therapy group and revascularization group were significantly increased (P <0.05) PⅠCP / PCⅢ, MMP-1 and TIMP-1 were significantly decreased (P <0.05). PⅠCP in each subgroup of revascularization group, PCⅢ in subgroup 1 week and MMP-1 in 6-month subgroup were lower than those in routine treatment group (P <0.05). Conclusion: Cardiac collagen remodeling appears after AMI. On the basis of routine treatment, revascularization can further inhibit cardiac collagen synthesis and degradation after AMI.