冠心病患者血浆内皮素水平与心脏收缩功能的研究

Correlation between myocardial function and plasma endothelin in patients with coronary heart disease

目的:观察冠心病(CHD)患者血浆内皮素(ET)水平的动态变化,并探讨其与心脏收缩功能的关系。方法:对62例CHD患者应用免疫放射分析方法(IRMA)测定发病后12、24、48、96 h和7 d的血浆ET水平。应用心脏超声测定其左心室射血分数(LVEF);并按纽约心脏协会(NYHA)分级标准进行临床心功能评定。结果:CHD患者血浆ET水平显著高于正常对照组(P<0.05),发病12 h即达到峰值,急性心肌梗死(AM I)组和心绞痛(AP)组分别为(127.9±24.1)和(84.1±20.3)ng/L。心功能不全患者ET水平高于心功能正常者,心功能Ⅰ,Ⅱ,Ⅲ,Ⅳ级患者的ET分别为(79.8±16.3)、(86.9±18.2)、(121.2±24.6)和(192.1±22.2)ng/L。进一步相关分析显示,血浆ET水平与LVEF值呈显著负相关(r=-0.26,P<0.05)。结论:CHD患者血浆ET水平在发病后12 h达到峰值,其升高程度不仅与心功能分级有相关性,而且可反映心脏收缩功能的受损程度。

Objective： To investigate the dynamic changes in the content of endothelin （ET） in the plasma of coronary heart disease （CHD） patients and the relationship between myocardial function and ET. Methods： The plasma ET levels of 62 CHD patients were measured by immunoradiometric assay （IRMA） at 12 h, 24 h, 48 h, 96 h and 7 d after the attack of CHD. The left ventricular ejection fraction （LVEF） was detected by echocardiography and the cardiac function was assessed according to the NYHA classification criteria. Results： The plasma ET level was significantly higher in the CHD patients than in the healthy controls （P 〈 0.05）. It peaked at 12 h after the attack of the disease, （127.9 ± 24.1 ） ng/L in the acute myocardial infarction group and （84.1 ± 20.3 ） ng/L in the angina pectoris group. It was also significantly higher in patients with heart failure than in those with normal heart function. The levels of ETwere （79.8±16.3） ng/L, （86.9±18.2） ng/L, （121.2±24.6） ng/Land （192.1± 22.2） ng/L respectively in patients with class Ⅰ , Ⅱ , Ⅲ and Ⅳ heart function. A negative correlation was found between ET levels and LVEF （ r = - 0.26, P 〈 0.05 ）. Conclusion ： Peaking at 12 h after the attack of CHD, the level of plasma ET is not only correlated with heart function but also a valuable laboratory plasma marker of the systolic function in CHD patients.