NGHIÊN cứu NỒNG độ MYELOPEROXIDASE HUYẾT TƯƠNG và LIÊN QUAN với mức độ NẶNG ở BỆNH NHÂN NHỒI máu cơ TIM cấp

NGHIÊN CU N MYELOPEROXIDASE HUYI LIÊN QUAN
VI M NNG  BNH NHÂN NHP

Nguyễn Thanh Định
1
, Huỳnh Văn Minh
2
1

2



Mục tiêu: nh n Myeloperoxidase huy bnh nhân nh
cp. Kho sát ma n Myeloperoxidase huy vi mt s thông s
cn lâm sàng (troponin T, CK, CK-MB, CRP, bch cu, bch cu trung tính, bilan lipid máu) và
m nng ca b m ca Selvester.
Đối tượng và phương pháp nghiên cứu: 


-


Kết quả: 
pmol/L,(137-
(25-70), (p < 0,001).      Nam(n=25, 507,4±368,7 pmol/  
614,1± 442,4 pmol/L, p=0,636).  -
--
      


± 516,6 pmol/L), p=0,237
(

2=4,126; p=0,121), CKMB (

2=3,900; p=0,142), TroponinT (

2=2,167; p=0,338),
CRP(

2=   

2=3,000; p=0,223), Neutro (

2=2,889; p=0,236),
Cholesterol (

2=3,000; p=0,223), Triglycerides (

2=1,182;p=0,554), HDL C (

2=0,348;
p=0,840), LDL C (

2=1,773; p=0,412).
Kết luận:  


Không 
               



SUMMARY
RESEARCH INTO PLASMA MYELOPEROXIDASE LEVELS AND THE RELATION
TO THE SEVERITY OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Objectives: Determining the plasma myeloperoxidase levels in acute myocardial infarction.
Finding out the interrelation between plasma myeloperoxidase levels and some paraclinical
markers: Troponin T, CK, CK-MB, CRP, WBC, WBNC, plasma lipid bilan, and the severity of
patients according to Killip classification and Selvester marks.
Subject and method: Disease group: 39 patients with acute myocardial infarction under
treatment in ICU of Hue central hospital and the university hospital of Hue college of medicin
and pharmacy. Normal group: 30 healthy people. Carrying out blood examination to find out the
levels of MPO and other markers: Troponin T, CK, CK-MB, CRP at the same time. Killip
classification at admition. Get Selvester marks on clearest ECG.
Cross study with classification of patients into groups and compare with some variables collected.
Results: At disease group: the means value of MPO are 507,4±368,7 pmol/L for male
(n=25), 614,1± 442,4 pmol/L for female (n=14), (p=0,636); 683,7 ± 582,4 pmol/L for under 50
year old group, 328,0 ± 177,9 pmol/L for 50-59 group, 657,9 ± 368,2 pmol/L for 60-69 group,
503,3 ± 254,1 pmol/L for 70-79 group, 508,4+528,5 pmol/L for over 80 year old group, p=0,609.
Plasma MPO levels according to Killip classification: 472,3 ± 309,1 pmol/L by class 1,
479,0 ± 378,4 pmol/L by class 2, 790,5 ± 765,8 pmol/L by class 3, 782,4 ± 516,6 pmol/L by
class 4, p=0,237.
There is no ralation between plasma MPO levels and other markers: CK (

2=4,126; p=0,121),
CKMB (

2=3,900; p=0,142),Troponin T (

2=2,167; p=0,338), CRP (


2=0,867; p=0,648), WBC
(

2=3,000; p=0,223), WBNC (

2=2,889; p=0,236), Cholesterol (

2=3,000; p=0,223), Triglycerides
(

2=1,182; p=0,554), HDL C (

2=0,348; p=0,840), LDL C (

2=1,773; p=0,412).
Conclusion: The plasma MPO levels are higher in patients with acute myocardial infarction.
The age and sex do not have any effect on plasma MPO levels. There is also no interrelation
between plasma MPO levels and the severity of the disease according to Killip classification and
Selvester marks and paraclinical markers: CK, CKMB, Troponin T, Triglycerides, HDL C, LDL
C. The interrelation between plasma MPO levels and CRP, WBC is not clear.

T V


 

       






 
 CK-u trung tính, bilan lipid máu) và




 
 

- 
-  tiêu chun chp theo tiêu chun mi ca ACC/AHA.
 ng (n=30): Chn ngu nhiên nh  c khe ti
Bnh ving i hc Hut tiêu chun: tình nguyn tham gia nghiên cu, có
 tui vi nhóm bnh, không có các yu t ch t
ngc, khám lâm sàng tim mng, kt qu ng.
Tiêu chun loi tr: 

.
Tiêu chun mi nhp ca ACC/AHA:






-
















 



 
              
ARCHITECT i 1000, phng pháp CMIA (th 
nh


khoa Sinh hóa, cho vào máy ly tâm quay 35.000 vòng/phút tro



 



  


X

SD
t
p
MPO (pmol/L)

545,8
394,4
6,923
< 0,001

46,3
12,3
Nhn xét: n MPO huya nhóm bng, s
khác bing kê (p < 0,001).
Bng 3.2. Phân b n MPO huyc tui ca nhóm bnh.
Nhóm tui
n
X

SD
F
p
<50

6 (15,4%)
683,7
582,4
0,682
> 0,05
50-59
4 (10,3%)
328,0
177,9
60-69
8 (20,5%)
657,9
368,2
70-79
13 (33,3%)
503,3
254,1

8 (20,5%)
508,9
528,5
Nhn xét: n MPO huy theo tng nhóm tui không có s khác bit có
ng kê (p>0,05).
Bng 3.3. Phân b n MPO huya nhóm bnh theo gii.
Gii
n
X

SD
F

p
Nam
25
507,4
368,7
0,226
P > 0,05
N
14
614,1
442,4
Nhn xét: n  MPO huy   i ca nhóm bnh g   
Không có s khác bing kê (p>0,05).
Bng 3.4. Phân nhóm n MPO huy nhóm bnh.
Nhóm MPO
n
X

SD
F
p
MPO1(<300 pmol/L)
13(33,3%)
214,2
52,4
46,399
< 0,001
MPO2(300-499 pmol/L)
13(33,3%)
426,6

59,1

13(33,3%)
996,7
362,5
Nhn xét: n MPO nhóm 3 cao gp 2 ln nhóm 2 và cao gp 4,5 ln nhóm 1. N
MPO nhóm 2 cao gp 2 ln nhóm 1. S khác bing kê (p < 0,001).
3.2. Liên quan n MPO huyi m nng ca bnh
 
Killip
MPO
F
p
X

SD
1
472,3
309,1
1,480
> 0,05
2
479,0
378,4
3
790,5
765,8
4
782,4
516,6



Bng 3.6. Liên quan n MPO huyi din tích nhm Selvester.
Thông s
Ch s
MPO
F
p
MPO1
MPO2
MPO3
Din tích nhi máu (%)
X

17,5
15,0
17,1
0,828
> 0,05
SD
7,0
7,0
8,3
Nhn xét: din tích vùng nh
khác bing kê gia din tích vùng nhi máu và các mc MPO huy
3.3. Liên quan n MPO huy cn lâm sàng
Bng 3.7. Liên quan n MPO huy cn lâm sàng nghiên cu.
Thông s
CLS
Phân loi

Nhóm MPO

2

p
MPO1
MPO2
MPO3
CK
(U/L)

0(0%)
0(0%)
2(15,4%)
4,126
> 0,05
> 190
13(100%)
13(100%)
11(84,6%)
CKMB
(ng/ml)

1(7,7%)
0(0%)
3(23,1%)
3,900
> 0,05
> 4,94
12(92,3%)

13(100%)
10(76,9%)
TroponinT
(ng/ml)

0(%)
1(7,7%)
2(15,4%)
2,167
> 0,05
> 0,1
13(100%)
12(92,3%)
11(84,6%)
CRP
(mg/L)

2(15,4%)
4(30,8%)
3(23,1%)
0,867
> 0,05
> 8
11(84,6%)
9(69,2%)
10(76,9%)
Bch cu
( x 10
3
/ml)


5(38,5%)
6(46,2%)
2(15,4%)
3,000
> 0,05
> 10
8(61,5%)
7(53,8%)
11(84,6%)
Neutro
( x 10
3
/ml)

4(30,8%)
6(46,2%)
2(15,4%)
2,889
> 0,05
> 7,5
9(69,2%)
7(53,8%)
11(84,6%)
CT
(mmol/L)

8(61,5%)
11(84,6%)

7(53,8%)
3,000
> 0,05
> 5,2
5(38,5%)
2(15,4%)
6(46,2%)
TG
(mmol/L)

11(84,6%)
10(76,9%)
12(92,3%)
1,182
> 0,05
> 2,3
2(15,4%)
3(23,1%)
1(7,7%)
HDL
(mmol/L)

11(84,6%)
10(76,9%)
11(84,6%)
0,384
> 0,05
> 0,9
2(15,4%)
3(23,1%)

2(15,4%)
LDL
(mmol/L)

8(61,5%)
11(84,6%)
9(69,2%)
1,773
> 0,05
> 3,4
5(38,5%)
2(15,4%)
4(30,8%)
EF (%)

> 55
2(15,4%)
2(15,4%)
1(7,7%)
0,459
> 0,05

11(84,6%)
11(84,6%)
12(92,3%)
Nhn xét: s khác bit các giá tr ca các thông s cn lâm sàng nghiên cu vi các mc
ng kê (p>0,05).

IV. B





                 
pmol/L (24-

Ndrepepa G 
-
Mocatta TJ 

Marshall CJ 
 (234,5-572,4) [4].
y n  tui và gii khác bi
thng kê. Kt qu nghiên cu ca chúng tôi phù hp vi kt qu ca WH Wilson Tang và cng
s nghiên cu trên 1895 bnh nhân bnh mch vành, không có khác bing kê
gia các mc MPO vi tui tác (p=0,329) và gii (p=0,098) [11]. Li-Teh Chang nghiên cu trên
128 bnh nhân nht qu không có s khác bit gia các mc MPO
vi tui tác và ging p=0,100 và 0,533) [2].
4.2. Kho sát mi liên quan các mc MPO vi m nng ca b nng
m ca Selvester
>0,05)






4.3. Liên quan n MPO huy cn lâm sàng

      -C, LDL-     là





-
 CK MB (p=0,394),




(r = 0,186, P 

cholesterol (r =- 0,081, p = 0,05). -C,
HDL-C [3]. Ouyang M 
                 
 
  

           -C, HDL-C, CK MB,



 


 

 

 





      

- 

- 
- Khôn

- 
CK, CKMB, Troponin T, Triglycerid, HDL C, LDL C.
- 


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khoa học hội nghị tim mạch miền Trung mở rộng lần thứ V, tr. 102-05.
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Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary
Intervention, Circulation Journal, 73: 726-731.
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