急性心肌梗塞患者溶栓时血浆肾素、血管紧张素、醛固酮和心钠素的变化  

THE ALTERATION OF PLASMA RENIN ACTIVITY,ANGIOTENSIN-Ⅱ ALDOSTERONE AND ATRIAL NATRIURETIC PEPTIDE DURING THROMBOLYTIC THERAPY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

作　　者：李润基[1] 莫振兆 窦敬权[1] 彭晓东[1] 邱丽清[1] 黎景梅[1] 

机构地区：[1]广东医学院附属医院

出　　处：《广东医学院学报》1996年第1期7-10,共4页Journal of Guangdong Medical College

摘　　要：对５４例急性心肌梗塞（ＡＭＩ）患者随机分为二组，在应用尿激酶（ＵＫ）静脉治疗前后行血浆肾素活性（ＰＲＡ）、血管紧张素（ＡｎｇⅡ）、醛固酮（ＡＬＤ）和心钠素（ＡＮＰ）的检测结果显示：溶栓组（２５例）与非溶栓治疗组（２０例）ＡＭＩ患者血浆ＰＲＡ、ＡｎｇⅡ、ＡＬＤ和ＡＮＰ水平均升高，经治疗后溶栓组ＰＲＡ、ＡｎｇⅡ和ＡＬＤ降低明显（Ｐ＜０．０１～０．００１），ＡＮＰ升高明显（Ｐ＜０．０１）与非溶栓组比较差异显著（Ｐ＜０．０５～０．０１）；溶栓组中又以并发心衰、休克和严重心律失常患者血浆ＰＲＡ、ＡｎｇⅡ和ＡＬＤ升高明显（Ｐ＜０．０５～０．０１）；ＡＮＰ水平亦以病危组升高明显（Ｐ＜０．０１）。表明ＵＫ静脉溶栓治疗能有效地再通梗塞相关动脉（ＩＲＡ），缓解心肌损伤的应激状态；而ＡＮＰ相应升高作为缓解心肌损伤，机体过度应激而起到反馈调节ＰＲＡ、ＡｎｇⅡ的作用。The changes of plasma renin activity(PRA),angiotensin Ⅱ(Ang Ⅱ), aldosterone(ALD)and atrial natriuretic peptide(ANP)were investigated in 45 patients with acute myocardial infarction(AMI).These patients were divided ramdonly into group A(n=25,recieved thrombolytic therapy)and group B(n=20,as control).The results showed that before treatment the plasma levels of PRA,Ang Ⅱ, ALD and ANP were increased in all patients and that after treatment the levels of PRA, Ang Ⅱ and ALD were significantly decreased(P<0.01～0.001) in group A. There were siginificant differences between group A and B (P<0.05～0.001),the increments of PRA,Ang Ⅱ and ALD in A group patients complicated with heart failure,shock or severe arrhythmia became much more siginificant(P<0.05～0.01)than in other ones;and the ANP level was also siginificantly higher (P<0.01)in the critical cases. The authors believe that thrombolytic therapy is an effectual remedy for recanlization of the infarct-related artery, and for reliveing the stress condition of myocardial injury. The ANP relative increase may play some role in reducing myocardial injury and excessive stress as the feedback adjustment of PR and Ang Ⅱ.

关 键 词：心肌梗塞 肾素 血管紧张素Ⅱ 心钠素 溶栓疗法 

分 类 号：R542.220.2[医药卫生—心血管疾病]