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目的:分析急性心肌梗死(AMI)患者血清抗心肌肌钙蛋白I自身抗体(cTnIAAb)与左心室重构的关系.方法:随机选取131例AMI患者,采用酶联免疫吸附试验检测血清cTnIAAb;在患者入院时和AMI发生随访1年后进行超声心动图检查,以左心室收缩末期容积(LVESV)增加15%以上为左心室重构标准;采用二分类Logistic逐步回归分析筛选与左心室重构相关的12个危险因素.结果:131例AMI患者中,23例(17.6%)患者血清cTnIAAb阳性,108例(82.4%) cTnIAAb阴性.剔除失访的41例, 90例患者中,21.1% 患者血清cTnIAAb阳性,78.9%患者 cTnIAAb阴性.血清cTnIAAb阳性患者和cTnIAAb阴性患者的入院时临床数据差异无统计学意义(P>0.05);随访1年后,有38例(42.2%)患者的心脏超声心动图LVESV与入院时相比增加超过15%,其中10例(52.6%)患者cTnIAAb阳性,18例(25.4%)cTnIAAb阴性.经二分类Logistic逐步回归分析,血浆B型利钠肽(BNP)峰值和血清cTnIAAb阳性为左心室重构的危险因素 [OR(95%CI)分别为1.001 (95%CI:1.000~1.002)和3.552(95%CI:1.148~10.989),P值均为0.028].结论:部分AMI患者血清中存在cTnIAAb,cTnIAAb阳性与AMI患者的左心室重构风险增加有关,cTnIAAb可能参与了AMI后左心室重构的病理生理过程.“,”Objectives: To analyze the relationship between cardiac troponin I autoantibody (cTnIAAb) and left ventricular remodeling in patients with acute myocardial infarction (AMI). Methods: A total of 131 AMI patients were enrolled. Serum levels of cTnIAAb were measured by ELISA. Echocardiography was examined at the onset of AMI and 1 year follow-up evaluation. Taking left ventricular end systolic volume (LVESV) increasing>15% as left ventricular remodeling, 2-classified logistic stepwise regression analysis was conducted to screen 12 risk factors related to left ventricular remodeling. Results: 23/131(17.6%) patients were with positive cTnIAAb and 82.4% with negative cTnIAAb. 49 patients lost contact and in the rest 91 patients, 21.1% were with positive cTnIAAb. Clinical information was similar between cTnIAAb positive and negative patients upon admission, P>0.05; echocardiography showed that 28 (42.2%) patients had LVESV increasing>15% by 1 year follow-up study whom including 10 (52.6%) patients with cTnIAAb positive and 18 (25.4%) negative. 2-classified logistic stepwise regression analysis indicated that BNP peak and positive cTnIAAb were the risk factors for left ventricular remodeling (OR=1.001, 95% CI 1.001-1.002) and (OR=3.552, 95% CI 1.148-10.989), both P=0.028. Conclusions: Serum cTnIAAb was positive in part of AMI patients which was related to increased risk of left ventricular remodeling; cTnIAAb might be involved in pathophysiological process of left ventricular remodeling in AMI patients.