冠脉造影正常的急性心肌梗死患者血管内皮功能的研究

The Clinical Study of Blood Vessel Endothelium Function on Acute Myocardial Infarction with Normal Coronary Angiogram

目的:探讨冠脉造影正常的心肌梗死患者的内皮功能。方法:选择急性心肌梗死患者42例,分别给予急诊或择期的冠脉造影及进一步的支架置入术,健康对照32例。分别检测三组患者血浆内皮素(ET)、一氧化氮(NO)水平,并对比分析两组患者的危险因素。结果:冠脉造影正常和异常组血浆ET水平显著高于对照组(P<0.01),而血浆NO水平显著低于对照组(P<0.01),而冠脉造影正常及异常组血浆ET、NO水平无显著性差异(P>0.05)。冠脉造影正常组合并高血压病、高脂血症、糖尿病等危险因素的比率明显少于冠脉造影异常组,而吸烟者的比率明显高于冠脉造影正常组(P<0.01)。结论:冠脉造影正常的心肌梗死患者与冠脉造影异常的心肌梗死患者同样都存在血管内皮功能异常,临床应充分重视,做好心肌梗死的二级预防。

Objective： To research the blood vessel endothelium function with normal coronary angiogram. Methods：42 cases acute myocardial, infarction patiens were given coronary angiogram and further stenting.according to the result of coronary angiogram.the totle patients were randomly divided into the normal coronary, angiogram group the abnomml coronary angiogram group and control group.the three group patients were respectivly detected the plasma level of endothelin（ET） and nitrogen monoxidum（NO）,and analysis the risk factor of the two groups. Results：Compared with the control group, the plasma level of ET were increased significantly both in the normal coronary angiogran group and in the abnormal coronary angiogram group （P〈0.01）.But the plasma level of NO were decreased significantly （P〈0.01） and the plasma level of ET and NO have no significantly difference （P〉0.05）between the two groups. In the normal coronary, angiogram group, the rate of complicating the risk factors such as hypertensive disease, hyperlipemia, diabetes was less than the abnormal coronary angiogram group.But the smoker was more than the abnormal coronary angiogram group.there were significantly difference between the two groups （P〈0.01）. Conclusions：There existed dysfunction of vascular endothelium in acute myocardial infarction pafiens with normal coronary angiogram. Should be paid close attention, and should zave secondary, oreventian of myocardial infarction.