急性心梗患者静脉溶栓和PTCA术后血浆内皮素和心钠素变化的研究

Study on the Changes of Plasma ET and ANP Levels After Vein Thrombolysis and PTCA in Patient with AMI

目的:探讨急性心肌梗死(AMI)病人静脉溶栓和PTCA术后不同时相血浆心钠素(ANP)与内皮素(ET)水平的变化及其和冠脉再狭窄发生的关系。方法:研究对象为我院住院的AMI病人52例,PTCA组24例,静脉溶栓组28例,均于治疗前和治疗后1d、1周、4周时采静脉血测定血浆ANP和ET浓度。结果:两组病人的ANP浓度在术后1d时显著升高,与术前比较差异显著(P<0.01),术后1周和4周时降低,与术前和术后1d时比较差异显著(P<0.01),ANP浓度在PTCA组和静脉溶栓组组间比较无显著差异。ET浓度在PTCA组术后1d、1周和4周时均显著高于治疗前水平(P<0.01),以术后1d时升高最明显,而溶栓组无变化,PTCA组与溶栓组组间比较差异显著(P<0.01)。结论:AMI病人PTCA术后血浆ET水平升高,可能与介入治疗过程中血管的过度扩张与血管内膜的损伤有关,但ET的增加与再狭窄的发生之间的关系尚需进一步研究。

Objective To investigate the changes of plasma endothelin （ET）, atrial natriuretic polypeptide （ANP） levels and relation of vascular restenosis after vein thrombolysis and PTCA in patient with acute myocardial infarction （AMI）. Methods Research has been conducted on 52 patient of AMI patients, 24 patient of PTCA and 28 patient of vein thrombolysis. ANP and ET levels were detected in 1 day, 1 week and 4 weeks after treatment and pretherapy. Results ANP levels had increased significantly in 1 day＇s groups of after treatment in all groups of patients （P 〈 0.01）. Nonetheless, ANP levels had decreased in one weeks＇ and four weeks＇ groups （P 〈 0.01）. No obvious difference was observed between the comparison of ANP levels in PTCA and vein thrombolysis groups. ET levels was higher than pretherapy level in 1 day, 1 week and 4 weeks groups. Among them, it increased most significantly in 1 day after therapy, with no change invein thrombolysis groups, PTCA groups differed from vein thrombolysis groups. Conclusion The increase of plasma ET levels in AMI patients may. due to excess expansion and damage of vascular endothelial in interventional therapy. However, the correlation between ET＇s increase and restenosis is pending for further investigation.