八肽胆囊收缩素、P物质与无症状心肌缺血和心绞痛发生关系的研究

INVESTIGATION OF PLASMA CHOLECYSTOKININ-8(CCK-8) AND SUBSTANCE P IN SILENT MYOCARDIAL ISCHEMIA(SMI) AND ANGINA PECTORIS

本文测定了无症状心肌缺血（ＳＭＩ）组（１５例）、心绞痛组（１１例）和对照组（７例）运动试验前后血浆八肽胆囊收缩素（ＣＣＫ－８）、Ｐ物质含量，探讨这两种神经调节肽与ＳＭＩ和心绞痛发生的关系。结果显示：①运动前３组血浆ＣＣＫ－８含量分别为４．５５±２．１８、５．１１±１．５９和５．３９±２．８４ｐｍｏｌ／Ｌ，３组之间比较无明显差异；运动后３组血浆ＣＣＫ－８含量分别为４．９１±１．０８、８．５６±１．５７和５．７３±２．４６ｐｍｏｌ／Ｌ，心绞痛组明显高于ＳＭＩ和对照组（Ｐ＜０．０１）。②运动前３组血浆Ｐ物质含量分别为２．１３±０．２８、２．１０±０．２１和２．１３±０．１６ｎｍｏｌ／Ｌ，３组间比较无明显差异；运动后３组分别为２．２５±０．２１、２．４６±０．２０和２．１８±０．１２ｎｍｏｌ／Ｌ，心绞痛组明显高于ＳＭＩ组和对照组（Ｐ＜０．０２）。结果表明：高血浆ＣＣＫ－８、Ｐ物质含量可能参与心绞痛的发生，心肌缺血时无症状可能与血浆ＣＣＫ－８、Ｐ物质含量未升高有关。

The study was designed to evaluate the role of plasma CCK-8 and substance P in SMI and angina pectoris so as to investigate the pathogenesis of SMI. In 15 patients with SMI(group 1) , 11 patients with effort angina(group 2) and 7 healthy controls (group 3) , the plasma levels of CCK-8 and substance P were measured by radioimmunoassay in resting state and immediately after exercise test. No statistical difference in both resting plasma CCK-8 and substance P levels among the three groups was found. However, after exercise, the plasma levels of CCK-8 in groups 1 , 2 and 3 were 4. 91±1. 08, 8. 56±1. 57 and 5. 73±2. 46pmol/L, respectively, while the plasma levels of substance P in groups 1, 2 and 3 were 2. 25±0. 21, 2. 46±0. 20 and 2. 18±0. 16 nmol/L, respectively. Both the plasma levels of CCK-8 and substance p in group 2were significantly higher than those in groups 1 and 3(p<0. 01 and p<0. 02, respectively). This results suggest that painful myocardial ischemia may be related to the increase of plasma levels of CCK-8 and substance P, and painless myocardial ischemia to the unchanged plasma levels of CCK-8 and substance P.