[Changes of serum hepatocyte growth factor in coronary artery disease].
[Changes of serum hepatocyte growth factor in coronary artery disease].
复制标题
冠心病患者血清肝细胞生长因子的变化[J].
作者：
H. Suzuki;M. Murakami;T. Kondo;M. Shibata;H. Ezumi;H. Okabayashi;M. Yorozuya;N. Makishima;Y. Hamazaki;M. Nakatani;A. Namiki;T. Katagiri
肝细胞生长因子（Hepatocyte growth factor，HGF）是一种内皮细胞特异性生长因子，参与内皮细胞的修复和侧支循环的形成，但其在冠心病中的作用尚不清楚。本研究测定了各种冠状动脉疾病患者血清HGF水平，以探讨其临床意义。采用酶联免疫吸附法测定了26例稳定型劳力型心绞痛、18例陈旧性心肌梗死、10例不稳定型心绞痛和21例急性心肌梗死患者血清HGF水平。选择11例神经循环衰弱患者作为对照组。肝素给药前，在心导管插入术时采集外周静脉血样。AMI组于再灌注后48、72小时、1、2、3、4周从外周静脉及冠状静脉窦取血。UAP组（0.41 +/- 0.12 ng/ml，p < 0.001）和AMI组（0.38 +/- 0.26 ng/ml，p < 0.05）的血清HGF水平明显高于对照组（0.19 +/- 0.09 ng/ml）。AMI组再灌注48小时外周静脉和冠状静脉窦血清HGF水平均达高峰（0.42 ± 0.16ng/ml和0.58 ± 0.23ng/ml），冠状静脉窦血清HGF水平明显高于外周静脉（p < 0.05）。外周静脉HGF峰值与肌酸激酶（CK）、CK-MB、射血分数和心脏指数无明显相关性。急性冠状动脉综合征患者血清HGF升高，提示内皮细胞损伤。HGF至少部分在AMI患者的心脏中产生。血清HGF水平可能有助于检测内皮细胞损伤而非心肌细胞损伤。
Hepatocyte growth factor (HGF) is an endothelial cell specific growth factor involved in the repair of endothelial cells and collateral formation, however, the role for coronary artery disease is still unknown. We measured serum HGF level in various coronary artery diseases to examine the clinical significance. Serum HGF level was measured using the enzyme-linked immunosorbent assay method in patients with stable effort angina pectoris (n = 26), old myocardial infarction (n = 18), unstable angina pectoris (UAP; n = 10) and acute myocardial infarction (AMI; n = 21). As a control group, we selected 11 patients with neurocirculatory asthenia. Blood samples from peripheral veins were collected at cardiac catheterization before heparin administration. In the AMI group, blood samples were also collected at 48, 72 hr, 1, 2, 3 and 4 weeks from the peripheral veins and 48 and 72 hr after reperfusion from the coronary sinus. Serum HGF level was significantly higher in the UAP (0.41 +/- 0.12 ng/ml, p < 0.001) and AMI groups (0.38 +/- 0.26 ng/ml, p < 0.05) compared to the control group (0.19 +/- 0.09 ng/ml). Serum HGF level peaked 48 hr after reperfusion in both the peripheral veins (0.42 +/- 0.16 ng/ml) and coronary sinus (0.58 +/- 0.23 ng/ml) in the AMI group, with a significantly higher level in the coronary sinus than the peripheral veins (p < 0.05). No significant correlation between peak HGF level in the peripheral veins and peak creatine kinase (CK), CK-MB, ejection fraction and cardiac index was observed. Serum HGF was elevated in acute coronary syndrome, indicating advanced endothelial cell damage. HGF is produced, at least partially, in the heart in patients with AMI. Serum HGF level may be useful to detect endothelial cell damage rather than myocardial cell damage.