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Objective :To explore relationship among levels of C reactive protein (CRP) ,mean platelet volume (MPV) and occurrence of no-reflow (NR) during primary percutaneous coronary intervention (PCI) in patients with acute ST elevation myocardial infarction (STEMI).Methods :Clinical and imaging data of 156 STEMI patients ,who received primary PCI from Jan 2015 to Dec 2016 ,were retrospectively analyzed .According to presence of NR during PCI ,patients were divided into NR group (n＝54) and no NR control group (n＝102).Multi-factor Logistic regression analysis was used to analyze influencing factors of NR occurrence .Results :Compared with no NR control group ,there were significant rise in percent-age of diabetes mellitus (23.5% vs.42.6%) ,levels of CRP [(31.7 ± 5.3)mg/Lvs.(64.5 ± 9.7)mg/L]and MPV [(9.31 ± 1.05)fl vs.(11.29 ± 0.98)fl] ,number of stents [(1.9 ± 0.4) vs.(2.1 ± 0.6)] and symptom-onset-to-balloon [SOTB , (254 ± 96)min vs.(315 ± 108)min] in NR group , P＜0.05 or ＜0.01. Multi-factor Logistic regression analysis indicated that diabetes mellitus ,SOTB ,levels of CRP and MPV were independent risk factors for NR occurrence (OR＝2.335～3.670 ,P＜0.05 or ＜0.01).Conclusion :Rise of CRP and MPV levels are independent risk factors for no-reflow during primary PCI in STEMI patients ,which possess certain predictive value for no-reflow occurrence and worth extending .
RESUMO
<p><b>AIM</b>To investigate the effects of hepatocyte growth factor gene transfected MSCs transplantation on cardiac function and fibrosis in rats heart failure model induced by adriamycin.</p><p><b>METHODS</b>MSCs were isolated from SD rats by density gradient centrifugation, purified, and transfected with Ad-hHGF. ELISA were used to detect the protein expression of hHGF in these MSCs. Forty SD rats underwent intraperitoneal injection with adriamycin to induce heart failure model. 8 healthy rats served as control, 24 survival rats were randomly divided into 3 groups (n = 8): Rats in Ad-hHGF transfected MSCs group were injected with Ad-hHGF transfected MSCs 2 weeks after the establishment of the model, rats in MSC group injected with suspension of MSCs only, and model group was injected with cold culture fluid. Heart function was evaluated by a physiological recorder 4 weeks after cell transplantation. Myocardial cell morphology and interstitial collagen were studied by electron microscope and were stained by Sirus red. TGF-beta1 was detected by immunohistochemical method.</p><p><b>RESULTS</b>(1) MSCs could be transfected efficiently by Ad-hHGF, manifested by a higher level of expression in vitro, persisting 14 days at least. (2) Four weeks after the cells transplantion, cardiac necrosis in MSC-hHGF rats was improved when compared with those in the MSCs (P < 0.05) and Model group (P < 0.01). The heart function of the MSC-hHGF rats was greatly improved with an significant increase in LVSP and + dp/dt(max), although LVEDP still highter than that of normal rats. (3) MSC-Ad-hHGF decreased Myocardial collagen content and the level of TGFbeta1 compaired with MSCs transplanted rats (P < 0.01).</p><p><b>CONCLUSION</b>Transplantation of HGF gene transfected MSCs improved heart function, decreased myocardial collagen and the level of TGFbeta1.</p>