Objective To investigate the association of serum angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) with myocardial reperfusion in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Methods A total of 103 consecutive STEMI patients who received primary PCI were enrolled in this study. The patients were divided into two groups according to ST-segment resolution (STR) at 2 h after PCI:STR ≥ 50%group (n=69) and STR<50%group (n=34). Serum concentrations of Ang-1, Ang-2 and Ang-2 to Ang-1 ratios (Ang-2/Ang-1) before and immediately after PCI, 2 h, 6 h, 24 h after PCI were compared. Predictors of poor STR were identiifed by multivariable logistic regression analysis. Results The patients with STR≥50%had significant higher serum Ang-1 levels (P < 0.05) and lower Ang-2/Ang-1 ratios (P < 0.01) from before PCI to 6 h after PCI than those with STR < 50%;Ang-1 and Ang-2/Ang-1 at 24 h after PCI, and Ang-2 at all time points were not signiifcantly different between the two groups (P>0.05). In multivariable logistic regression analysis, Ang-2/Ang-1 before PCI was independently associated with STR < 50%;Other independent predictors were pain to balloon time, infarct related artery (LAD), and TIMI flow grade<Ⅲafter PCI. Conclusions Higher Ang-2/Ang-1 is an independent predictor of poor myocardial reperfusion in STEMI patients after PCI.%目的：探讨直接经皮冠状动脉介入治疗（PCI）ST段抬高急性心肌梗死（STEMI）患者的血清血管生成素-1（Ang-1）和血管生成素-2（Ang-2）与心肌再灌注的相关性。方法连续入选103例诊断为STEMI并接受直接PCI的患者，根据术后2 h心电图ST段回落（STR）分为STR≥50％组（69例）和STR＜50％组（34例）。比较两组PCI术前和术后即刻、2 h、6 h、24 h的血清Ang-1、Ang-2及Ang-2和Ang-1的比值（Ang-2/Ang-1）。用多因素Logistic回归分析心电图STR不佳的危险因素。结果 STR≥50％组术前至术后6 h Ang-1显著高于STR＜50％组（P＜0.05），而Ang-2/Ang-1显著低于STR＜50％组（P＜0.01）；术后24 h Ang-1和Ang-2/Ang-1及各时间点Ang-2两组间差异无统计学意义（P＞0.05）。多因素Logistic回归分析显示，术前Ang-2/Ang-1升高、发病至置入球囊时间延长、梗死相关动脉为左前降支（LAD）和术后TIMI血流＜Ⅲ级是STEMI患者心电图STR不佳的独立危险因素。结论直接PCI术前Ang-2/Ang-1升高可作为STEMI患者PCI后心肌再灌注不佳的预测指标之一。
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