经皮腔内冠状动脉成形术后内皮素心脏释放动力学的研究  

Study on the heart release kinetics of endothelin after percutaneous transluminal coronary angioplasty(PTCA)

作　　者：姜立清[1] 于波[2] 胡大一[1] 

机构地区：[1]首都医科大学同仁医院心脏中心,北京100730 [2]哈尔滨医科大学附属第二医院心内科

出　　处：《中国急救医学》2004年第5期316-317,共2页Chinese Journal of Critical Care Medicine

基　　金：北京市科技基金资助项目 (No .H0 10 2 10 3 3 0 113 )

摘　　要：目的　对经皮腔内冠状动脉成形术 (PTCA)后内皮素 (ET)释放的动力学进行估价 ,探讨冠状动脉内皮是否是ET的释放部位。方法　 12例冠脉造影前后、2 0例陈旧性心肌梗死行择期PTCA术前及术后 5min、6h的股静脉血、冠状动脉口血及冠状窦处血 ,用放射免疫法检测ET浓度。结果　冠脉造影前后血浆ET浓度无明显变化 (P >0 0 5 )。PTCA术后 5minET浓度升高 ,与术前相比具有极显著性差异 (P <0 0 1) ,且持续升高达 6h ,与术前相比具有极显著性差异 (P <0 0 1)。PTCA后冠状动脉口、冠状窦及股静脉处ET浓度均明显升高 ,但冠状窦处最高 ,其与冠状动脉口及股静脉相比均具有显著性差异 ,且冠状动脉口与股静脉处ET浓度相比也具有显著性差异。结论　PTCA可使血浆ET进一步升高 。Objective This study was designed to assess the release kinetics of endothelin after percutaneous transluminal coronary angioplasty(PTCA) and to prove the coronary endothelium as the source of the endothelin release.Methods 20 patients with outmoded myocardial infarction (OMI) underwent PTCA and 12 patients accepted coronary angiography.Blood samples were withdrawn from the peripheral vein,coronary sinus(CS),coronary artery(CA) and femoral vein (V) before operation and 5 minutes,6 hours after operation.Concentration of plasma endothelin were determined by radioimmunoassay.Results The PTCA group had more level of plasma endothelin.There was no significant difference between pre-CAG and post-CAG ( P >0 05).The levels of plasma endothelin in PTCA increased significantly at 5 minutes and 6 hours ( P <0 01) after PTCA.The concentration of endothelin in coronary sinus was the highest.There was significant difference between CS and CA ( P <0 01) and between CS and V ( P <0 01). Conclusion Levels of plasma endothelin increased significantly after PTCA and coronary endothelium might be the source of the endothelin release.

关 键 词：冠状动脉成形术 冠脉内皮 内皮缩血管肽 

分 类 号：R541.4[医药卫生—心血管疾病]