文章摘要
巨敏 王蕊 张君毅 朱迪 刘毅 陶凌.Irisin 水平与急性心肌梗死患者PCI术后无复流的研究[J].,2015,15(35):6852-6856
Irisin 水平与急性心肌梗死患者PCI术后无复流的研究
Effect of the SerumIrisin Level in Predicting Angiographic Reflow AfterPrimary Percutaneous Coronary Intervention in Patients With AcuteMyocardial Infarction
  
DOI:
中文关键词: Irisin  急性心肌梗死  无复流现象  经皮冠状动脉介入术(PCI)
英文关键词: Irisin  Acute myocardial Infarction  No-reflow  Percutaneous coronary intervention
基金项目:国家自然科学基金青年基金项目(81400201),陕西省重点科技创新团队基金项目(IRT-14208)
作者单位
巨敏 王蕊 张君毅 朱迪 刘毅 陶凌 第四军医大学西京医院心血管内科空军工程大学门诊部心血管内科陕西省地质矿产勘查开发局职工医院心内科 
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中文摘要:
      目的:探讨血清Irisin 水平对急性心肌梗死(AMI)患者PCI术后无复流的预测价值。方法:连续收集西京医院心内科因AMI 行急诊PCI治疗的169 例患者的临床及冠脉影像学资料。根据TIMI血流分级,将病人分为两组,正常血流组和无复流组;采用酶 联免疫吸附试验(ELISA)检测患者血清中Irisin 水平,根据Irisin 水平分为低Irisin 组和高Irisin 组,分析Irisin 与无复流发生的关 系。结果:①169例患者发生无复流40 例,无复流发生率为23.6%(40/169);②无复流组与正常血流组相比,血清Irisin 水平显著降 低(4766± 1725 ng/mLvs 8125± 2904 ng/mL,P<0.05);③急性心梗发生后,血浆Irisin 水平逐渐升高,3 小时内组Irisin 水平显著低 于24 小时后组(4050± 1739 ng/mL vs8358± 3042 ng/mL,P<0.05),且3 小时内组无复流显著高于24 小时后组(71.42%vs 12.9%, P<0.05);④低Irisin 组中无复流的发生率显著高于高Irisin 组(58.1% vs 11.9%,P<0.05);⑤多元Logistic 回归显示Irisin 是急诊 PCI术后无复流发生的保护因素(OR:0.861,95%CI:0.793-0.909,P<0.05)。结论:低水平的血清Irisin 能有效预测急性心肌梗死患者 PCI术后无复流的发生,且Irisin 能明显改善PCI术后无复流。
英文摘要:
      Objective:To assess the predictive value of serum Irisin level in patients with no-reflow after PCI with acute myocardial infarction.Methods:A total of 169 patients with AMI underwent primary PCI were collected from clinical and angiography findings fromthe department of Cardiology of Xijing Hospital. According to thrombolysis in myocardial infarction(TIMI) flow grade, the patients were divided into normal-reflow group and (no-reflow)NR group after primary PCI. Serum Irisin levels were measured by ELISA. According to serumIrisin levels, the patients were divided into low Irisin group and high Irisin group, to determine the relationships of Irisn and the incidence of no-reflow.Results:①There were 40 patients in the no-reflow group. No-reflow occurred in 23.6% of the AMI patients after primary PCI(40/169); ②After AMI, the level of serum Irisin in no-reflow group was significantly decreased compared with the control group (4766± 1725 ng/mL vs 8125± 2904 ng/mL, P<0.05);③the level of serum Irisin was gradually increased in the first 24 hours in AMI .Within 3 hours group, the serum Irisin was gradually decreased compared with more than 24 hours group (4050± 1739 ng/mL vs 8358± 3042 ng/mL, P<0.05). The incidence of no-reflow was gradually declined compared with more than 24 hours group (71.42%vs12.9%, P<0.05); ④ The incidence of no-reflow in low Irisin group significantly decreased compared with that of high Irisin group(58.1%vs 11.9%, P<0.05); ⑤Multiple logistic analysis identified Irisin as the protective predictor of no-reflow after primary PCI in AMI (OR:0.861,95%CI:0.793-0.909, P<0.05).Conclusion:Low serum Irisin levels is a strong and independent predictor of slow flow/no-reflow after PCI in patients with AMI, and Irisin can significantly improve the no-reflow after PCI.
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