心力衰竭与急性心肌梗死患者神经内分泌水平的动态观察

Neuroendocfine Changes in Congestive Heart Failure and Acute Myocardial Infarction

通过测定血浆PRA、AII、Ald、ANP及AVP浓度的变化,研究比较CHF和AMI时神经内分泌水平的动态演变。发现CHF患者神经内分泌水平显著高于AMI患者,随着临床症状改善CHF患者神经内分泌水平逐渐下降。AMI患者各项指标变化不一致,PRA及AII在住院第4天显著高于第1天和第8天的水平,ANP及AVP血浆浓度在发病第1天最高,此后逐渐下降。综上认为,神经内分泌兴奋性的升高是CHF发生的主要原因,但在AMI时却是疾病导致的结果。

Plasma levels of renin (PRA) ,angiotenin II(AII) ,aldosterone(Ald) ,atrial natriuretic peptide (ANP)and arginine vasopressin (AVP) were measured in patients with congestive heart failure (CHF) or acute myocardial infarction (AMI), The results showed that the levels of all the aforementioned hormones were significantly higher in patients with CHF than with AMI. With amelioration of clinical symptoms of heart failure. elevated neuroendocrine levels decreased slowly from admission till day 8. Neuroendocrine changes in AMI were complex. Plasma PRA and AH concentration were significantly higher on day 4 than on admission and on day 8. Plasma levels of ANP and AVP were shown to be maximal on admission, folio wed by a decline. The study suggested that neuroendocrine activity contributed to the pathogenesis of congestive heart failure. In contrast, AMI caused neuroendocrine activation.