| Objective: To investigate the mechanism of TMZ treatment on AMI through observing the early changes of the serum levels of adiponectin(Adp) and resistin(Res) in patients with first acute myocardial infarction(AMI).Methods: In this study, 50 patients with first AMI who were treated in the Department of Cardiology of the Affiliated Hospital of North Sichuan Medical College from December 2008 to July 2009 were randomly divided into TMZ group and control group(25cases respectively). Both groups received conventional therapy at the first two weeks when enrolled (aspirin, low molecular heparin sodium, clopidogrel, atorvastatin calcium, and so on. According to the conditions of the patients, Thrombolytic therapy or PCI were given.). In addition to conventional therapy, the TMZ group administered TMZ 20 mg, 3 times per day. The history of these patients'such as blood pressure as well as height,weight, body mass index(BMI) were recorded in detail and the fasting blood glucose(FBG),lipid,cardiac troponin I(cTnI), Adp, Res and so on were measured right after admission. After one week and two weeks intervention, Adp and Res were investigated again. The serum levels of Adp and Res were detected by enzyme linked immunosorbent assay (ELISA).Results:⑴The serum concentrations of Adp gradually increased in both of the TMZ group and control group after one week and two weeks of treatment respectively. In the TMZ group, the serum concentrations of Adp increased obviously after one week and two weeks of treatment as compared with that of pre-treatment(p<0.05, respectively), while there was no significant difference between the one week and two weeks of the Adp concentration(p>0.05). While the marker mentioned above showed no significant differences in the control group(p>0.05, respectively).⑵The serum concentrations of Res gradually decreased in both of the TMZ group and control group. In the TMZ group, the concentration of Res decreased obviously at one week and two weeks of treatment as compared with that of pre-treatment(p<0.05, respectively), and the concentration of Res got further decreasing at two weeks than that of one week(p<0.05); While there was no difference of the marker in the control group in each of the checkpoint as mentioned previously(p>0.05).⑶TMZ can increase the serum concentrations of Adp in patients with AMI while decrease Res obviously instead(p<0.05). And the concentration of Adp increased faster in TMZ group than that of control group, while Res concentration decreased faster in TMZ group than that of control group(p<0.05).⑷The serum concentration of Adp in patients with AMI was positively related with high density lipoprotein cholesterol(HDL-C) and apolipoprotein A (ApoA) before treatment(p<0.001, respectively) and negatively related with BMI, cTnI and Res(p<0.05, p<0.001, p<0.001, respectively); the serum concentration of Res in patients with AMI was positively related with cTnI(p<0.001) before treatment; while negatively correlated with HDL-C, ApoA and Adp(p<0.001, respectively); After part of the clinical risk factors were corrected, the significant correlations mentioned above still exist.Conclusion: The serum concentrations of Adp increased obviously while that of Res decreased significantly in patients with AMI in the presence of TMZ. TMZ therapy can protect myocardial cells not only through optimizing the metabolism of cardiac energy but also affecting the early serum concentrations of Adp and Res in patients with AMI. High serum level of Adp may serve as an AMI protective factor, while high serum level of Res could be the hazardous factor of AMI.
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