| Background: With the development of the sociaeconomic, the traditional lifestyle have changed as well as the populations aged ever more rapidly, the morbidity of coronary heart disease and acute myocardial infarction(AMI) are present rises year by year, so our health have suffered from serious threats. Although many new drugs and the myocardial revascularization treatment have applied in clinic, which should play important roles in reduce the mortality of patients with coronary heart disease, especially the AMI, the latest research results show that the mortality of AMI were not significantly reduced in recent 10 years in China. The main reason is related to the delay of emergency revascularization. So there still don’t have a safe and effective method which can completely reverse the damage from myocardial ischemia. Especially the patients with AMI, there are still heart function fails although active treatment. So if we can find a effect method which promote myocardial regeneration and angiogenesis, then the myocardial blood supply would be increased and the myocardial would be repaired, finally the living quality and clinical prognosis of the AMI patients would obviously improved. At present, a lot of basic research and animal experiments have confirmed that thymosin beta4(Tβ4) can promote the proliferation, differentiation, migration and angiogenesis of cardiac progenitor cells, besides, Tβ4 paly important roles in improving the blood-supply of ischemic myocardial, reducing the injury of myocardial, promoting the repair of cardiac muscle and so on. But little clinical research has been done of Tβ4 for heart protection. The dynamic changes ofTβ4 in AMI patients,and the relationship with Tβ4’s expression level in vivo and the prognosis of AMI have not been reported.Objective:We observe the dynamic changes trend of Tβ4’s plasma level and related indicators in AMI patients within 15 days after sick, discuss the influence and the significance in the different treatments to the dynamic changes trend of Tβ4’s plasma level and related indicators.Discuss the relationship between the expression level of Tβ4 in the patients with AMI and relationship between the prognosis of AMI.Methods:Selected the 69 patients as experimental group who were hospitalized in cardiovascular department of yijishan hospital of wannan medical college between October 2013 to June 2014,and they were diagnosed definitely with AMI. According to the different therapy methods,the experimental group was divided into three subgroups:the primary percutaneous coronary intervention(p PCI) subgroup,the delay percutaneous coronary intervention(d PCI) subgroup, the optimal medicine treatment(OMT) subgroup.In addition,we choose 32 volunteers as control group who were specifically excluded from coronary artery stenosis through coronary angiography(CAG). Collect the venous blood of all object of study on admission, and the experimental group patients 2 hours after primary PCI, 15 days after hospitalization respectively. Using enzyme-linked immunoassay(ELISA) method measured the level of Tβ4 and vascular endothelial growth factor(VEGF), basic fibroblast growth factor(b FGF) in plasma.And the patients in experimental group needed to be follow-up on 8 months.Results: 1,Compared with the control group,Tβ4, VEGF, b FGF levels in plasma of experimental group on admission were significantly increased respectively(P<0.01). 2, After the intervene of active therapy on the patients in experimental group,the levels of Tβ4, VEGF, b FGF in plasma were all elevated after onset,and declined from 1 days after the onset gradually, and reached to the lowest in third day,then rised again and reached to the highest in sixth day,then declined gradually again.While in 10 th to 11thdays the indicators rised smally, until in 15 th day the levels of indicators above were still higher than the control group significantly(P<0.05).3,At the beginning of the illness,the dynamic changes of these three cytokines in the three subgroups of experimental group were dfifferent obviously:the levels reached to the peak in the p PCI subgroups within 12 hours and then declined gradually,while rising again after the third day.However,they continuous elevated within 6 days in d PCI subgroups and OMT subgroups. 4,In p PCI subgroup of experimental group,the patients whose plasma Tβ4, VEGF, b FGF levels in 2 hours after receive treatment and next day after in the hospital were all significantly increased(P<0.05).However, in d PCI subgroup,there were no statistical significance between the plasma concentrations of the three cytokines in 1 day of preoperative and 1 day of postoperative who have received PCI(P>0.05). 5,Compared with the patients in experimental group expienced MACE during the follow-up periods,no MACE occurred patients, during the hospitalization periods,the averages of the MAX level of Tβ4 were significantly higher, a statistically significant difference(P<0.01).Conclusions: 1, AMI could induces the up-regulation of the expression of Tβ4,VEGF and b FGF in vivo. 2, The levels of Tβ4,VEGF and b FGF of AMI patients’ plasma first increase and then decrease on the whole in early stage. 3, The dynamic change trend of Tβ4,VEGF and b FGF of AMI patients’ plasma levels in early stage could be greatly affacted by different terapeutic methods. 4, The high expression of AMI patients’ Tβ4 contribute to improve the prognostics of AMI patients. It may be a new terapeutic methods to use exogenous Tβ4 to treat AMI patients, and this study may lay a theoretical foundation for it. |
PDF Full Text Request