尿激酶对急性心肌梗死血浆心钠素的影响

Influence of Thrombolytic Therapy on Plasma Atrial Natriuretic Peptide in Acute Myocardial Infarction

对40例急性心肌梗死患者血浆的心钠素水平检测结果显示，急性心肌梗死患者各测定时点的血浆心钻素值明显高于正常人水平，差异显著（P＜0．01），并于入院当时（病后5．07±3．08小时）达高峰（0．69±0．54ng／ml），以后逐渐降低．于48小时时再次达高峰（0．69±0．34ng／ml），于72小时时仍未恢复至正常人水平（健康正常人血浆心钠素水平为0．49±0．08ug／ml）。在缺血性心肌损伤早期，血浆心钠素水平即升高，低氧血症可能是刺激心钠素早期释放的原因。尿激酶溶栓治疗20例病人的血浆心钠素水平较非溶栓治疗的20例病人的血浆心钠素水平明显降低，且下降较快，第二峰值降低。各测定时点血浆心钠素水平比较，差异非常显著（P＜0．05，P＜0．01）。溶栓使血浆心钠素降低的原因可能与血液动力学失调有关，或者可能因尿激酶具有纤维蛋白和纤维蛋白原降解产物的血管舒张作用。血浆心钠素浓度的降低可能提示尿激酶具有短暂的有益的血液动力学作用。

Plasma concentrations of immunoreactive atrial natriuretic peptide were measured in 40 patients admitted to the emergency department with acute myocardial infarction.Concentration were significantly higher in patients than in healthy persons(p＜0.01). Before treatment or 5. 07± 3. 08 hours after onset,the mean plasma atrial natriuretic peptide was elevated (0. 69±0. 54ng/ml). Then,it decreased gradually. The mean plasma atrial natriuretic peptide elevated to peak amount again at 48 hours after treatment. lt was still higher than normal level(0. 49±0. 08ng/ml) at 72 hours after treatment. Hypoxia is The cause of atrial natriuretic peptide release. concentrations were significantly lower in patients treated with intravenous urokinase and the second peak of value was lower than that in patients not so treated. Reasons of thrombolytic therapy decreased atrial natriuretic peptide may be related with hemodynamic abnormality and urokinase may have vasodilative effect on fibrin and fibrinogen degradation products.