血浆神经肽Y水平与冠状动脉病变程度的关系

A Clinical Observation on Plasma Neuropeptide Y Levels and the Severity of Coronary Artery Atherosclerosis

目的:观察血浆神经肽Y(NPY)水平与冠状动脉病变程度的关系。方法:选择符合WHO诊断标准的急性心肌梗塞(AM I)20例,心绞痛(AP)20例,应用放射免疫法动态观察40例冠状动脉造影主要分支狭窄程度>50%的患者和20例冠状动脉造影正常者的血浆NPY含量变化,并作冠状动脉病变程度记分,观察NPY含量变化与冠状动脉记分的关系。结果:正常对照组NPY水平为(145.1±44.1)ng/L,AM I组发病第1天NPY含量达峰值,为(230.10±35.24)ng/L,显著高于正常对照组(P<0.05),发病第3天开始下降,第1周末趋于正常,为(173.58±44.54)ng/L。AP组于心绞痛发作期NPY含量为(234.26±43.26)ng/L,亦显著高于正常对照组(P<0.05),经治疗2周症状缓解后复查血浆NPY含量下降至(135.17±36.75)ng/L,前后比较有显著差异(P<0.05);NPY水平与冠状动脉狭窄程度记分呈显著正相关(P<0.01)。结论:NPY水平在冠心病患者发病初期显著升高,其升高可能由于心肌缺血急性期交感神经兴奋性提高,释放活性增强所致。提示NPY参与了冠心病的发病及病理生理过程。

Objective： To investigate the relationship between plasma neuropeptide Y （NPY） levels and the severity of coronary artery atherosclerosis of patients. Methods： Radioimmunoassy was applied to determine plasma NPY levels. This study includes 40 patients （20 cases of acute myocardial infarction, AMI, and 20 cases of argina pectoris, AP） with fixed stenosis coronary artery 〉50% of luminal diameter in the dominant branch coronary arteries, and 20 healthy people proved by coronary artery angio-graphy as control. The relationship between plasma neuropeptide Y levels and the coronary artery score were assessed. Results： Plasma NPY level of control group was （145.10 ±44.10）ng/L. That of group AMI was （230.10 ±35.24） ng/L on the first day, which was higher than that of control group （P 〈0.05） , and began to decrease on the third day, and reached the normal value, （173.58 ±44. 54 ） ng/L, in one week. The NPY level of group AM was（234.26± 43.26） ng/L during the disease attack and was higher than that of control group （ P 〈 0.05 ）. It decreased to （ 135.17± 36.75 ） ng/L after 2 weeks of treatment. It was significantly different from that before the treatment （ P 〈 0.05 ）. Conclusions： Plasma NPY might be related to the severity of coronary artery atherosclerotic heart disease. The parallel trend between the increase in plasma NPY level and the severity of coronary artery atherosclerosis suggests that NPY be involved in the progress of the disease.