急性冠脉缺血综合症患者血浆内皮素和内啡肽的变化及意义  

Plasma ET and β-EP levels and its value in patients with acute coronary artery ischemia syndrome

作　　者：林朝胜[1] 王凯庚[1] 赵凯[1] 贺顺川[1] 

机构地区：[1]沈阳军区总医院

出　　处：《心血管康复医学杂志》2002年第1期5-7,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的 :观察急性冠脉缺血综合征 (ACIS)几种血浆介质的变化及意义。方法 :6 5例 ACIS患者被分为 AMI组(4 3例 ) ,不稳定型心绞痛组 (2 2例 ) ,于其发病后 12、 14、 48小时和 2 0天检查血肌酸激酶同工酶 (CK- MB)、内皮素 (ET)、β内啡肽 (β- EP)水平。结果 :ET峰值 :AMI组、心绞痛组分别为发病 12小时的 2 88.4± 80 .6 pg/ml,2 45 .1± 6 3.4pg/ml;β- EP峰值 :AMI组为 2 4小时的 2 10 .9± 5 0 .2 pg/ml,心绞痛组为 12小时的 15 4.2± 47.6 pg/ml;CK-MB>15 0 U/L 组 :β- EP2 40 .5± 42 .6 pg/ml,ET30 2 .4± 5 8.1pg/ml,明显高于 CK- MB<10 0 U/L组的 (P<0 .0 5 )。心功能 级患者 :β- EP 2 48.6± 2 7.3pg/m l,ET 311.6± 45 .2 pg/ml,明显高于心功能正常组 (P<0 .0 5 )。结论 :(1) ACIS发病后 β- EP在 2 4小时达到峰值 ,升高程度与心肌缺血坏死程度有关 ,它是 AMI后心衰的病理性介质之一 ;(2 ) ACIS发病后 ET迅速升高 ,12小时达到峰值 ,是急性损伤时的一种内源性致病因子 ,能诱发冠状动脉痉挛和血小板聚集。Objective:To demonstrate the plasma endothelin(ET )and endorphin(β-EP) levels and to reseach its clinical valur in patients with acute coronary ischemia syndrome(ACIS).Methods:Sixty-five patients with ACIS were divided to AMI group(43 cases),unstable angina pectoris(UAP) group (22 cases),their CK-MB?ET and β-EP levels were measured at 12,24,48 h and 20 day after episode.Results:The top level of ET was 288.4±80.6pg/ml in AMI group and 245.1±63.4pg/ml in UAP group at 12 h;The top level of β-EP was 210.9±50.2pg/ml in AMI group at 24 h and 154.2±47.6pg/ml in UAP group at 12 h;ET and β-EP levels in group of CK-MB>150U/L were higher than those in group of CK-MB <150U/L( P <0.05);ET and β-EP levels in patients with heart failure increased more than those in patients with normal heart function.Conclusion:(1)Plasma β-EP level increased to top level at 24 h after ACIS related to the level of impairment of ischemia,it is a pathogenic mediator of heart failure after AMI;(2)Plasma ET levels is obviously increase to top level at 12 h after ACIS,it is a pathogenic mediator inducing coronary artery spasm and platelet agglutination.

关 键 词：急性冠脉缺血综合征 内皮素 内啡肽 ACIS 心肌酸激酶同工酶 

分 类 号：R54[医药卫生—心血管疾病]