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目的 :探讨急性心肌梗塞过程中血浆心房肽 (ANP)、脑钠素 (BNP)浓度的变化。 方法 :1用放射免疫法测定 2 7例急性前壁心肌梗塞患者入院即刻、入院后第 1天至第 7天、第 14天和第 30天及 6 0名对照者的血浆 ANP、BNP浓度。 2用放射性核素 99m锝心血池扫描测定发病后 7天及 30天的左心室射血分数。 结果 :2 7例患者血浆 ANP浓度仅于入院时、入院后第 1天和第 2天显著高于正常对照组 (P<0 .0 1) ,而 BNP浓度则在所测各时间点均高于正常对照组 (ANP、BNP的正常值分别为 35 .6± 4.6 pg/ ml和 11.7± 2 .3pg/ ml)。血浆 ANP浓度入院时已达到峰值 ,而血浆 BNP的峰值在入院后第 2天出现。血浆 BNP浓度和与时间对应的左心室射血分数之间存在较密切的负相关 (r=- 0 .5 2 ,P<0 .0 5 ;r=- 0 .6 5 ,P<0 .0 1)。 结论 :急性心肌梗塞后血浆 ANP、BNP浓度显著升高且后者入院后出现峰值 ,心肌缺血损伤和收缩功能降低可能是引起血浆 BNP浓度升高的原因之一。
Objective: To investigate the changes of plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) during acute myocardial infarction. Methods: 1 Plasma ANP and BNP concentrations were measured by radioimmunoassay in 27 patients with acute anterior myocardial infarction immediately after admission, 1 day to 7 days after admission, 14 days and 30 days and 60 controls. 2 Left ventricular ejection fraction at 7 and 30 days after onset with radionuclide 99m Tc cardioplegia scan. Results: The plasma ANP concentrations in 27 patients were significantly higher than those in the normal control group (P <0. 01) on admission and on the first and second days after admission, while the BNP levels were significantly higher at all time points The normal control group (ANP, BNP normal values were 35.6 ± 4.6 pg / ml and 11.7 ± 2.3pg / ml). Plasma ANP concentrations peaked at admission, whereas plasma BNP peaked on day 2 after admission. There was a close negative correlation between plasma BNP concentration and left ventricular ejection fraction corresponding to time (r = -0.52, P <0.05; r = - 0.65, P <0. 0 1). Conclusion: After acute myocardial infarction, plasma ANP and BNP levels were significantly increased and the latter peaked after admission. The decrease of myocardial ischemic injury and contractile function may be one of the reasons leading to the increase of plasma BNP concentration.