血清vaspin、IL-6水平对急性心肌梗死后左室重构的评估价值

目的:观察冠脉介入治疗的急性心肌梗死(AMI)患者的左室重构与血清脂肪特异性丝氨酸蛋白酶抑制剂(vaspin)和白介素-6(IL-6)水平的相关性。方法:入选的研究对象(50例)均来自于2018年9月～2019年6月就诊于同济大学附属普陀人民医院且被诊断为AMI的住院患者,患者均经早期经皮冠脉介入(PCI)治疗,术后规范药物治疗。采用酶联免疫吸附实验(ELISA)测定50例患者发病后1天、7天、30天的血清vaspin和IL-6水平并行超声心动图检查。同时以50例健康体健者作为对照组。比较两组间血清vaspin、IL-6水平的差异,观察AMI后血清vaspin、IL-6水平的变化趋势及其与左室重构的指标包括左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)的相关性。结果:(1)对照组血清vaspin水平为6.03±1.18 ng/mL,AMI组血清vaspin水平4.22±1.37 ng/mL,AMI组血清vaspin水平明显低于对照组(P0.05),且AMI后1月内血清vaspin水平逐渐降低(P0.05);对照组血清IL-6水平为12.04±3.97 ng/mL,AMI组血清IL-6水平为26.72±10.06 ng/mL,AMI组患者血清IL-6水平明显高于对照组(P0.05),且AMI后1月内血清IL-6水平逐渐升高(P0.05);(2)经相关性分析显示:AMI后1天、7天、30天血清vaspin水平与LVEDD、LVESD均呈负相关(P0.05),血清IL-6水平与LVEDD、LVESD均呈正相关(P0.05),血清vaspin水平与IL-6水平均呈负相关(P0.001)。结论:急性心肌梗死后早期,左室重构的进展伴随着血清vaspin的降低与IL-6的升高,临床上应监测两种指标的变化,对左室重构早期干预,预防心力衰竭的发生。

The Value of Serum Vaspin and IL-6 Levels in Evaluating Left Ventricular Remodeling after Acute Myocardial Infarction

ABSTRACT Objective: To observe the correlation between left ventricular remodelling and visceral adipose tissue-derived serine proteinase inhibitor (vaspin) and interleukin-6(IL-6) levels in patients with acute myocardial infarction(AMI) undergoing coronary intervention. Methods: The selected subjects (50 Cases) were from the hospitalized patients of Putuo People''s Hospital affiliated to Tongji University during September 2018 to June 2019, who were diagnosed with AMI. All patients were treated with early percutaneous coronary intervention(PCI) and with standardized drug therapy. Enzyme-linked immunosorbent assay(ELISA) was used to measure serum vaspin and IL-6 levels in 1 day, 7 days, and 30 days after PCI and all the patients were accepted echocardiography. At the same time, 50 healthy human subjects were enrolled in the control group for comparison. The serum vaspin and IL-6 levels between the two groups were compared. The changes of serum vaspin and IL-6 levels after AMI and their correlation with the indicators of left ventricular remodeling including left ventricular end diastolic diameter (LVEDD) and left ventricular end systole diameter (LVESD) were observed. Results: (1) The serum vaspin level in the control group was 6.03±1.18 ng/mL, and the serum vaspin level in the AMI group was 4.22±1.37 ng/mL. The serum vaspin level in the AMI group was significantly lower than that in the control group (P<0.05). The serum vaspin level gradually decreased within 1 month after AMI (P<0.05). The serum IL-6 level in the control group was 12.04±3.97 ng/mL, and the serum IL-6 level in the AMI group was 26.72±10.06 ng/mL. The serum vaspin level in the AMI group was significantly higher than in the control group (P<0.05). Serum IL-6 levels gradually increased within 1 month after AMI (P<0.05). (2) Correlation analysis showed that serum vaspin levels were negatively correlated with LVEDD and LVESD (P<0.05), serum IL-6 levels were positively correlated with LVEDD and LVESD (P<0.05), and serum vaspin levels were negatively correlated with IL-6 levels (P<0.001) in Day 1, Day 2, Day30 after AMI. Conclusion: On early acute myocardial infarction, the progress of left ventricular remodeling is accompanied by the decrease of vaspin and the increase of IL-6 level. Clinically, the changes of the two indicators should be monitored after AMI. We should focus on early intervention for left ventricular remodeling to prevent heart failure.