目的 探讨急性心肌梗死患者血清8-羟基脱氧鸟苷(8-OHdG)与胸痛起病到就诊时间即院前延误时间(PDT)及早期预后的关系.方法 69例行急诊经皮冠状动脉介入治疗(PCI)的急性ST段抬高性心肌梗死患者,按PDT分为≤6 h组和＞6 h组.检测入院时及PCI术后24 h血清8-OHdG、肌酸激酶同工酶(CK-MB)水平,2周后,行超声心动图检查,检测左室射血分数(LVEF).另设胸痛患者20例为对照组,行冠状动脉造影排除冠心病,检测入院时及冠状动脉造影术后血清8-OHdG水平.结果 心肌梗死患者入院时及PCI术后24 h血清8-OHdG水平均显著高于对照组(P＜0.01),PCI术后24 h血清8-OHdG、CK-MB水平较入院时明显升高(P＜0.05);与PDT≤6 h组比较,PDT＞6 h组血清8-OHdG、CK-MB水平显著升高(P＜0.01),LVEF明显降低(P＜0.05);PDT≤6 h组及PDT＞6 h组8-OHdG水平与LVEF呈负相关(r值分别为-0.543和-0.594,P＜0.01).结论 急性心肌梗死患者的血清8-OHdG水平与PDT相关,并在评估心功能方面有重要临床意义.%Objective To observe the association between the level of serum 8 - hydroxy - 2' - deoxyguanosine ( 8 - OHdG ) and prehospital delay time ( PDT ) as well as prognosis in patients with acute ST - elevation myocardial infarction ( ASTE-MI ). Methods A total of 69 patients underwent percutaneous coronary intervention ( PCI ) for ASTEMI were divided into two groups according PDT:≤6 h group and > 6 h group, with another 20 patients of non - coronary artery disease confirmed by coronary angiography ( CA ) served as the control group. Serum levels of 8 - OHdG and CK - MB were measured at hospitalization and 24 h after PCI with cardiac function and LVEF examined 2 weeks later. Results Serum 8 - OHdG levels in the ASTEMI groups were significantly higher than in the control group at hospitalization and 24 h after PCI ( P <0. 01 ). Serum 8 - OHdG and CK - MB levels increased significantly 24 h after PCI compared with at hospitalixation ( P < 0. 05 ). Compared with the ≤6 h group, 8 - OHdG and CK - MB levels in the > 6 h group increased significantly ( P < 0. 01 ) while cardiac function in the > 6 h group decreased significantly ( P <0. 05 ). Serum 8 - OHdG levels were negatively correlated with cardiac function in both the ≤ 6 h group and the >6 h group ( r = -0. 543 , -0. 594 ) ( P <0. 01 ). Conclusion Serum 8 - OHdG is correlated with prehospital delay time and has important clinical values in assessing heart failure in patients with ASTEMI.
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