急性心肌梗死患者血浆内啡肽的动态变化及意义

Change of plasma β-endorphin in patients with acute myocardial infarction

目的:探讨急性心肌梗死(AMI)患者血浆β-内啡肽(β-EP)的动态变化及临床意义。方法:对22例AMI患者应用固相免疫放射分析方法测定发病后12、24、48、96h和7天血浆β-EP水平。结果:AMI患者血浆β-EP水平显著高于正常对照组(P<0.05)并呈现明显动态变化,发病12h内开始升高,24h达峰值(104.2±30.1)pg/ml,1周左右恢复正常。肌酸激酶同工酶(CK-MB)>100U/L者的β-EP为(144.3±31.0)pg/ml,明显高于CK-MB≤100U/L者的(70.8±18.9)pg/ml(P<0.05)。AMI患者血浆β-EP水平与CK-MB峰值呈正相关(r=0.455,P<0.05),与血清肌钙蛋白T(CTnT)水平呈显著正相关(r=0.562,P<0.01)。心功能不全者的β-EP水平明显高于心功能正常者,且与心功能严重程度呈显著正相关(r=0.602,P<0.01)。结论:β-EP在AMI发病后24h达到峰值,其升高程度与间接反映心肌梗死面积的CK-MB、CTnT以及心功能变化密切相关。

Objective ：To study the change of plasma endorphin （β-EP） in patients with acute myocardial infarction （AMI）. Methods：At 12, 24, 48, and 96 h and 7 d after episode, the plasma levels of β-EP were measured with an immnoradiometric assay （IRMA） in 22 patients with AMI. Results ： The plasma levels of β-EP in 22 patients with AMI were higher than those in 20 healthy subjects （ P 〈 0.05 ）. It increased within 12 h after episode, reached to the top at 24 h （ 104.2 ± 30.1 ） pg/ml and returned to normal after one week. The plasma levels of β-EP in group of CK-MB 〉 100 U/L were higher than those in group of CK-MB ≤ 100 U/L （P 〈 0.05 ）. The plasma levels of β-EP in patients with AMI were positively correlated with the top levels of CK-MB （ r = 0.455, P 〈 0.05 ） and troponin T （ r = 0.562, P 〈 0.01 ）. The plasma levels of β-EP in AMI patients with heart failure were higher than those with normal heart function and had a positive correlation with heart failure severity （ r = 0.602, P 〈 0.01 ）. Conclusion ：Topping at 24 h after episode in patients with AMI, the plasma level of β-EP is related to the area of AMI and the heart function.