急性心肌梗塞患者溶栓治疗后内皮素水平变化的观察

Observation on changes of plasma endothelin levels after thrombolytic therapy in patients with acute myocardial infarction

目的：探讨急性心肌梗塞（ＡＭＩ）患者溶栓治疗后内皮素（ＥＴ）变化规律，以及溶栓后冠状动脉（冠脉）再通与未通者ＥＴ变化的异同。方法：应用放免技术和酶法分别测定了ＡＭＩ常规治疗组（２１例）和溶栓组（１９例）患者梗塞后ＥＴ和肌酸激酶同功酶（ＣＫＭＢ）的动态变化。结果：溶栓组ＥＴ较常规治疗组提前４小时达峰值，且ＥＴ值高于常规治疗组。溶栓组ＣＫＭＢ峰值时间较常规治疗组提前２小时，而ＥＴ又比ＣＫＭＢ峰值时间提前４小时。溶栓冠脉再通组于梗塞后第８和第１０小时ＥＴ值均高于未通组，Ｐ均＜０．０５。再通组ＥＴ峰值时间较未通组提前２小时。ＡＭＩ有并发症组ＥＴ峰值和最大差值分别高于无并发症组，对应值间比较，Ｐ＜０．０１和Ｐ＜０．００１。结论：ＡＭＩ时ＥＴ升高，有并发症者升高更明显，溶栓冠脉再通后ＥＴ峰值提前。提示ＥＴ可能作为冠脉再通的评价指标之一。脉）再通与未通患者ＥＴ变化特点。１资料与方法１．１研究对象：①常规治疗组：２１例中男１４例，女７例；平均年龄（６２．４±２０．７）岁。②溶栓组：１９例中男１３例，女６例；平均年龄（５８．７±１７．１）岁。根据溶栓冠脉再通临床评定标准〔１〕，将本组１９例分为再通组（１２例）和未通组（７例）?

Objective:To investigate the changes in plasma endothelin (ET) levels after thrombolytic therapy in patients with acute myocardial infarction (AMI).Methods:AMI patients were divided into 2 groups:routine treatment group (n=21) and thrombolysis group (n=19).ET levels in patients were determined by radioimmunoassay.Results:The ET peak level in thrombolysis group was 4 hours earlier than that in routine group,and thrombolysis group kept higher ET levels than routine group.In all AMI patients plasma CKMB was also tested and the dynamic changes of which were compatible with the ET fluctuation,but in thrombolysis group the peak time of ET was even earlier than that of CKMB.There were 14 AMI patients with complications,they had higher ET levels than those without complications.Conclusions:Following AMI,the ET levels can be markedly increased,which are higher in patients with complications than those without complications.Also,the peak time of ET appears to be earlier in patients with coronary artery patency after thrombolysis than those with coronary artery occlusion.Therefore,ET may be a useful marker for coronary artery patency after thrombolysis.