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目的：探讨急性心肌梗塞（ＡＭＩ）患者溶栓治疗后内皮素（ＥＴ）变化规律，以及溶栓后冠状动脉（冠脉）再通与未通者ＥＴ变化的异同。方法：应用放免技术和酶法分别测定了ＡＭＩ常规治疗组（２１例）和溶栓组（１９例）患者梗塞后ＥＴ和肌酸激酶同功酶（ＣＫＭＢ）的动态变化。结果：溶栓组ＥＴ较常规治疗组提前４小时达峰值，且ＥＴ值高于常规治疗组。溶栓组ＣＫＭＢ峰值时间较常规治疗组提前２小时，而ＥＴ又比ＣＫＭＢ峰值时间提前４小时。溶栓冠脉再通组于梗塞后第８和第１０小时ＥＴ值均高于未通组，Ｐ均＜０．０５。再通组ＥＴ峰值时间较未通组提前２小时。ＡＭＩ有并发症组ＥＴ峰值和最大差值分别高于无并发症组，对应值间比较，Ｐ＜０．０１和Ｐ＜０．００１。结论：ＡＭＩ时ＥＴ升高，有并发症者升高更明显，溶栓冠脉再通后ＥＴ峰值提前。提示ＥＴ可能作为冠脉再通的评价指标之一。脉）再通与未通患者ＥＴ变化特点。１资料与方法１．１研究对象：①常规治疗组：２１例中男１４例，女７例；平均年龄（６２．４±２０．７）岁。②溶栓组：１９例中男１３例，女６例；平均年龄（５８．７±１７．１）岁。根据溶栓冠脉再通临床评定标准〔１〕，将本组１９例分为再通组（１２例）和未通组（７例）?
Objective: To investigate the changes of endothelin (ET) after thrombolytic therapy in patients with acute myocardial infarction (AMI) and the similarities and differences of ET after coronary artery recanalization and inoperation after thrombolysis. Methods: The dynamic changes of ET and creatine kinase isoenzyme (CKMB) after infarction in AMI routine treatment group (21 cases) and thrombolytic group (19 cases) were determined by radioimmunoassay and enzymatic method respectively. Results: Compared with the conventional treatment group, ET in the thrombolytic group reached the peak 4 hours earlier and the ET value was higher than that in the conventional treatment group. The peak time of CKMB in thrombolytic group was 2 hours earlier than that of conventional treatment group, and ET was 4 hours earlier than CKMB peak time. Thrombolytic coronary recanalization group at the eighth and tenth hours after infarction, ET values were higher than the non-pass group, P <0.05. Re-group ET peak time than the group did not advance 2 hours. The peak and maximum difference of ET in complication group were higher than those in non-complication group respectively, P <0.01 and P <0.001, respectively. Conclusions: The ET increased at AMI, the complication increased more obviously, and the peak of ET after thrombolysis coronary artery recanalization came earlier. It is suggested that ET may be one of the evaluation indexes of coronary recanalization. Pulse) recanalization and failure of patients with ET characteristics. 1 Materials and Methods 1.1 Study: ① conventional treatment group: 21 cases of 14 males and 7 females; mean age (62.4 ± 20.7 years). Thrombolytic group: 19 males and 13 females, 6 females; mean age (58.7 ± 17.1) years old. According to thrombolysis coronary recanalization clinical evaluation 〔1〕, the group of 19 cases were divided into reperfusion group (12 cases) and failed group (7 cases)?