中文摘要：

目的观察急性冠脉综合征（ACS）患者血浆成纤维细胞生长因子21（FGF21）的动态变化,分析其在ACS心肌缺血再灌注损伤中的作用,探讨其与患者近期预后是否有关。方法选取99例ACS患者行急诊经皮冠状动脉介入治疗（PCI）术前、术后即刻、术后72h血样,采用酶联免疫吸附法检测分析FGF21的动态变化,分析ACS患者术前、术后即刻、术后72h后的血浆FGF21浓度,并将ACS患者术前FGF21浓度与32例对照组的FGF21比较,研究两者的区别,探讨FGF21与再灌注治疗的关系,随访3个月观察患者近期预后。结果 ACS组患者术前FGF21浓度较对照组低,其值分别为（0.434±0.09）ng/ml和（0.616±0.07）ng/ml,ACS组患者术后即刻浓度较术前明显降低,其值分别为（0.254±0.076）ng/ml和（0.408±0.074）ng/ml,术后72h明显升高,其值分别为（0.887±0.039）ng/ml和（0.459±0.037）ng/ml。将ACS组按是否成功开通罪犯血管分为未处理组和再通组,分析发现未处理组较再通组术后即刻FGF21浓度高,术后72h的FGF21浓度低。随访3个月,发现冠状动脉病变数目多者预后差（RR=6.285,P〈0.05）,女性较男性预后差（RR=6.481,P〈0.05）。结论心肌缺血损伤可导致血浆FGF21浓度降低,成功开通罪犯血管可使FGF21浓度明显升高,说明成功开通罪犯血管对FGF21浓度有影响,FGF21浓度变化与心肌缺血损伤存在相关性。随访观察发现,女性患者及三支病变患者主要负性心脏事件发生率较高,FGF21浓度变化对ACS患者3个月预后无明显影响。

英文摘要：

Objective To explore the value of fibroblast growth factor-21（FGF21）in diagnosing acute coronary syndrome（ACS）and evaluating the effect of reperfusion treatment through observing dynamic changes of plasma fibroblast growth factor 21 levels in ACS patients.Methods We selected 99 ACS patients undergoing percutaneous coronary intervention（PCI）,by collecting preoperative,postoperative and 72-hour blood samples,using enzyme-linked immunosorbent assay to analysize the dynamic changes of preoperative and normal control patients.At the same time,by the analysis of preoperative,postoperative and 72-hour plasma concentration of FGF21,we tried to explore the relationship with reperfusion therapy.Results The plasma FGF21 level was lower in ACS group than in normal control group,the value was（0.434±0.09）ng/ml vs.（0.616±0.07）ng/ml（P0.001）respectively.In ACS group,plasma FGF21 concentrations were lower in post-than in preoperation,the values were（0.254±0.076）ng/ml vs.（0.408±0.074）ng/ml（P0.001）respectively.However,at 72-hour the values were（0.887±0.039）ng/ml vs.（0.459±0.037）ng/ml（P0.001）.Our study found that plasma FGF21 levels in ACS patients before PCI were lower than that in the normal control group,which were much higher at 72-hour after procedures.The data showed higher FGF21 concentration in untreated group than in reopen group at reperfusion,thereafter getting lower at 72-hour.After 3-month follow-up,we found that the number of diseased coronary artery had poor prognosis（RR=6.285,P0.05）as well as the,we also female sex（RR=6.481,P0.05）.Conclusions FGF21 is a protective fator to ACS.Plasma FGF21 levels is different between normal people and ACS patients and it is proportional to the severity of pathological changes.