急性心肌梗死患者溶栓后神经肽Y、一氧化氮、超氧化物歧化酶、丙二醛含量变化及其临床意义

The clinical meaning of changes of serum levels of NYP, NO, SOD and MDA after thrombolytic therapy for acute myocardial infarction

目的探讨急性心肌梗死(AMI)患者溶栓前后血清神经肽Y(NPY)、一氧化氮(NO)、超氧化物歧化酶(SOD)、丙二醛(MDA)的含量变化及临床意义。方法测定108例健康人和171例AMI患者溶栓前及溶栓后1、2、3、24、48和72h血清中NPY、NO、SOD和MDA的含量。结果与健康人比较,溶栓前患者NPY和MDA含量升高,NO和SOD含量降低(P<0.05)。溶栓后1～3h的再通组与溶栓前及未通组比较,NPY和MDA含量更高,而NO和SOD含量更低(P<0.01)。再通组的NPY和MDA高峰出现在溶栓后2h,而NO和SOD的低谷恰好也出现在溶栓后2h。溶栓24h后再通组NPY和MDA含量下降,而NO和SOD含量升高(P<0.05),其变化幅度大于未通组(P<0.01)。结论AMI后溶栓1～3h内NPY和MDA明显升高,NO和SOD明显下降,可能参与溶栓后早期内皮功能损伤。

Objective To evaluate the clinical meaning of changes of serum levels of neuropeptide Y （NYP） ,nitric oxide （ NO）, superoxide dismutase （SOD） and malondialdehy （MDA） before and after thrombolytic therapy for acute myocardial infarction （AMI）. Methods Serum concentrations of NPY, NO, SOD and MDA were detected before and 1,2, 3, 24, 48, and 72 h after thrembolytic therapy in AMI patients （ n = 171 ） and in health people （ n = 108 ） as control. Results Compared with healthy people, concentrations of NPY and MDA increased and NO and SOD decreased significantly before thrombolytic therapy （ P 〈 0.05 ）. NPY and MDA were higher, NO and SOD were lower after successful therapy at 1 to 3 h than those before therapy or after failure therapy （ P 〈 0.05 ）. The highest level of serum NPY and MDA, and the lowest level of serum NO and SOD appeared at 2h in patients who underwent thrombolytie therapy successfully. Then NPY and MDA decreased and NO and SOD increased significantly in patients who underwent thrombolytic therapy successfidly, compared with failure therapy group, （P 〈0.01 ）. Conclusions Serum level of NPYand SOD increased and NO and SOD decreased significantly after successful thrombolytic therapy for AMI, which might be associated with endothelium injury induced by thrombolytic therapy.