冠心病患者血浆ET、TXB_2、6-Keto-PGF_(1α)的观察

Observations on Plasma Levels of ET,TXB_2,6-Keto-PGF_(1α) in Patients with Coronary Heart Disease

目的:探讨血浆内皮素(ET)、血栓素(TXB2)、6-酮-前列腺素1α(6-Keto-PGF1α)在冠心病患者发病中的变化及临床意义。方法:放射免疫分析测定25例不稳定型心绞痛(UA):22例急性心肌梗死(AM I)和35例正常对照血浆。结果:三组年龄对比无显著性差异(P>0.05),UA组心绞痛发作期与终止期比较及AMI组溶栓前与溶栓后比较有显著性差异(P<0.01)。结论:ET的过度分泌加剧了血小板的激活,导致TXB2/6-Keto-PGF1α比例失调;三者共同参与冠状动脉痉挛和血栓形成过程;短时间内ET的过度分泌与TXB2/6-Keto-PGF1α代谢失调促进与加强加速了UA向AMI的转化。

Objective To explore the chinical significance of changes of plasma levels of ET, TXB2 and 6 - Keto - PGF1α during attacks in patients with coronary heart disease （CHD）. Methods Plasma ET, TXB2 and 6 - Keto - PGF1α, levels were determined with RIA in 25 patients with unstable angina （UA） both during and after the angina attack, 22 patients with acute myocardial infarction （AMI） both before and after thrombolytic therapy and 35 controls. Results Plasma levels of ET and TXB2 in UA patients during angina attack and AMI patients before thrombolytic therapy were significantly higher than those in UA patients after attack and AMI parents after thrombolytic therapy respectively （P 〈 0.01）. The reverse was true for 6 - Keto - PGF1α i. e. significantly lower during attack and before thrombolytic therapy. Conclusion Over secretion of ET during cardiac events would result in overactivation of platalets with increase of TXB2 and decrease of 6 - Keto - PGF1α, which would potentiate coronary arterial spasm and thrombosis formation.