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目的:探讨急诊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33例AMI患者分别予常规药物治疗(常规组,14例)和急诊血运重建治疗(急诊组,19例),应用酶联免疫法分别检测AMI后1周、6个月及12个月的血清Ⅰ型前胶原羧基端肽(PⅠCP)、Ⅲ型前胶原(PCⅢ)、基质金属蛋白酶-1(MMP-1)及组织抑制因子-1(TIMP-1)含量。以30例正常人为对照组。结果:与对照组比较,常规组和急诊组各时点的PⅠCP、PCⅢ均明显增高(P<0.05),MMP-1和TIMP-1均显著降低(P<0.05)。急诊组6个月的PⅠCP、PCⅢ和12个月的PCⅢ均低于常规组同期相应指标(P<0.05),急诊组6个月的TIMP-1高于同期常规组(P<0.05)。结论:急诊血运重建抑制AMI后中期(6～12个月)心脏胶原重构的作用强于常规药物治疗。
Objective: To investigate the effects of emergency revascularization on cardiac collagen synthesis and metabolism in patients with acute myocardial infarction (AMI). Methods: Thirty-three patients with AMI underwent routine medical therapy (routine group, 14 cases) and emergency revascularization (emergency group, 19 cases). The levels of AMI were measured at 1 week, 6 months and 12 months (PⅠCP), type Ⅲ procollagen (PC Ⅲ), matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) 30 normal subjects as control group. Results: Compared with the control group, the levels of PⅠCP and PCⅢ were significantly increased (P <0.05) and the levels of MMP-1 and TIMP-1 in the routine group and the emergency group were significantly decreased (P <0.05). The PⅠCP, PCⅢ and PCⅢ in the emergency group were lower than those in the conventional group at 6 months (P <0.05). The TIMP-1 at 6 months in the emergency group was higher than that in the routine group (P <0.05). CONCLUSION: Emergency revascularization suppresses the remodeling of cardiac collagen in the mid-term (6-12 months) after AMI.