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).  -
--
      


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

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 (




 
 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:






-


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


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

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



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

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)

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%)




                 
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

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

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


1. Kỷ yếu toàn văn các đề tài
khoa học hội nghị tim mạch miền Trung mở rộng lần thứ V, tr. 102-05.
2. Li-Teh Chang (2009), Level and Prognostic Value of Serum Myeloperoxidase in
Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary
Intervention, Circulation Journal, 73: 726-731.
3. Lukas Kubala (2008), Plasma Levels of Myeloperoxidase are not Elevated in Patients
with Stable Coronary Artery Disease, Clin Chim Acta. 394(1-2): 5962.
4. Marshall CJ (2010), Factors influencing local and systemic levels of plasma
myeloperoxidase in ST-segment elevation acute myocardial infarction, Am J Cardiol,
106(3):316-22.
5. Mocatta TJ (2007), Plasma concentrations of myeloperoxidase predict mortality after
myocardial infarction, J Am Coll Cardiol, 49(20):1993-2000.
6. Ndrepepa G (2008), Myeloperoxidase level in patients with stable coronary artery
disease and acute coronary syndromes, Eur J Clin Invest, 38(2):90-6.