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用特异性放射免疫法检测了急性心肌梗塞(AMI)和心绞痛(AP)患者不同病期血浆内皮素(ET)的浓度。结果显示,AMI的血浆ET水平在入院后即刻升高达峰值(40.77±2.304pg/ml),第1天开始逐渐下降,至恢复期(第28天)仍较高(14.14±1.456pg/ml);不同时期的ET浓度依次为AMI组>AP组(25.63±2.285pg/ml)>对照组(6.35±0.441pg/ml),P<0.001。提示组织在缺血、缺氧状态下引起ET的大量释放,是机体释放的一种内原性致损伤因子。AMI早期血浆ET浓度与血清肌酸激酶(CK)的活力变化一致,故ET水平可做为AMI早期诊断的敏感指标之一。梗塞范围越大、有严重心律失常时血浆ET水平升高越明显;并发泵衰竭死亡者,死者ET持续升高,显示血浆ET水平升高的幅度与心肌病变的严重程度密切相关。硝酸甘油与硝苯吡啶可能有部分抑制ET的缩血管和心脏效应。
The levels of plasma endothelin (ET) at different stages of acute myocardial infarction (AMI) and angina pectoris (AP) were detected by specific radioimmunoassay. The results showed that the level of plasma ET in AMI peaked immediately after admission (40.77 ± 2.304pg / ml), gradually decreased from day 1 to 14.14 ± 1.456pg / ml until recovery (day 28) ; ET concentrations in different periods were AMI group> AP group (25.63 ± 2.285pg / ml)> control group (6.35 ± 0.441pg / ml), P <0.001. It is suggested that the tissue can cause massive release of ET during ischemia and hypoxia and is an endogenous factor of injury induced by the body. AMI early plasma ET concentration and serum creatine kinase (CK) activity changes, so the level of ET can be used as a sensitive indicator of AMI early diagnosis. The larger the infarct size, the more significant the plasma ET level rises when there is serious arrhythmia. The death of those who died of pump failure continues to increase, indicating that the magnitude of plasma ET level is closely related to the severity of myocardial lesions. Nitroglycerin and nifedipine may partially inhibit vasoconstriction and cardiac effects of ET.