关键词: 线粒体天门冬氨酸氨基转移酶, 冠心病, 急性心肌梗死, 经皮冠状动脉介入治疗术, Gensini积分

Abstract:

Objective To evaluate the performance of immunosuppressive assay for mitochondrial aspartate aminotransferase（m-AST）,and to investigate the changes of serum aspartate aminotransferase（AST）,m-AST and m-AST/AST in patients with coronary heart disease（CHD） and acute myocardial infarction（AMI）. Methods The determination performance（precision,accuracy,linear range,reference interval,maximum dilution ratio）of immunosuppressive assay for m-AST was evaluated. Totally,44 patients with CHD undergoing drug-eluting stent implantation and 44 emergency patients with AMI undergoing percutaneous coronary intervention（PCI） were enrolled. Preoperative and postoperative AST and m-AST levels were determined,the ratio of m-AST/AST was calculated,and their correlations with Gensini score were analyzed. Results The precision,accuracy,linear range and reference interval of immunosuppressive assay for m-AST were all verified,which met the clinical requirements,and the maximum dilution ratio was 1∶10. There was no statistical significance in the levels of AST,m-AST and m-AST/AST between CHD patients before and after PCI（P>0.05）. The levels of AST,m-AST,cardiac troponin T（cTnT）,creatine kinase MB isoenzyme mass（CK-MB mass） and N-terminal B-type natriuretic peptide（NT-proBNP） in AMI patients after PCI were higher than those before PCI（P<0.05）,and the m-AST/AST was lower than that before PCI（P<0.05）. There was no statistical significance in the levels of AST,m-AST and m-AST/AST between CHD patients and AMI patients with different Gensini scores before and after operation（P>0.05）,and there was no correlation between AST,m-AST,m-AST/AST and Gensini score before and after operation（P>0.05）. The levels of AST and m-AST before operation,as well as AST,m-AST and m-AST/AST after operation in AMI patients were higher than those in CHD patients（P<0.05）,but there was no statistical significance in m-AST/AST before operation（P>0.05）. Conclusions The changes of serum AST,m-AST and m-AST/AST are related to the degree of myocardial cell injury,but not to the development of atherosclerotic plaque,so they can reflect the myocardial injury and recovery of AMI patients.

Key words: Mitochondrial aspartate aminotransferase, Coronary heart disease, Acute myocardial infarction, Percutaneous coronary intervention, Gensini score