摘要
目的观察冠心病急性心肌梗死(AMI)患者溶栓治疗前后血浆心肌营养素-1(CT-1)和B-型尿钠肽(BNP)变化及意义。方法①溶栓组于溶栓即刻、溶栓后2、4、6、8、10、12 h测定血中CT-1和BNP浓度;②未溶栓组于症状出现后2、4、6、8、10、12、14 h测定血中CT-1和BNP浓度。同时测定血清心肌酶CK-MB的浓度。结果①AMI后2～7 d,患者NBP水平明显升高,平均为(544.5±321.2)ng/L,明显高于正常对照组(P<0.01);CT-1在AMI患者症状出现后(2.43±1.30)h升高,水平明显高于正常对照组(P<0.01),并可在(4.09±2.14)h时达到高峰;②未再通组CT-1水平低于再通组,而BNP浓度高于再通组(P<0.05或P<0.01),未再通组CT-1和BNP浓度与未溶栓组之间无显著区别。结论①AMI患者血清中很早即可测得较高浓度的CT-1,水平明显高于正常对照组,时间早于CK-MB升高的时间;BNP升高时间相对较晚;②溶栓再通组可于溶栓后可检测到明显升高的CT-1但随着病情改善迅速降低,而BNP水平反而降低,故认为CT-1和BNP可以作为判定AMI溶栓治疗是否再通的指标之一。
Objective To observe the significance and changes serum B-type natriuretic peptide and cardiotrophin-1 in the patients with acute myocardial infarction（AMI）before and after thrombolytic therapy.Methods Serum concentrations of BNP and CT-1 were determied in thrombolysis group in the instantly,2,4,6,8,10,12 h after thrombolytic therapy,and no thrombolysis group in 2,4,6,8,10,12,14 h after onset of symptoms,serum enzyme CK-MB concentration were determied simultaneous.Results ①Serum CT-1 concentration would be elevated after the onset of complaints in patients with AMI,earlier than that with CK-MB（P0.01）;Serum BNP concentration would be elevated in patients with AMI.②SerumCT-1 concentration of vascular patency group was markedly higher than that of vascular no-patency group at 2,4,6 and 8 h after thrombolytic treatment（P0.01）,BNP and CT-1 concentration of vascular no-patency group was not different from the group which did not receive thrombolytic treatment.Conclusion ①Serum CT-1concentration will be elevated in the early phase in AMI,earlier than CK-MB.BNP and CT-1 concentration is markedly higher that of the control.BNP and CT-1 may be thought to be one of the reference markers of the diagnosis in early phase of AMI.②A markedly high concentration of CT-1 will be measured at 4,6 and 8 h after thrombolytic treatment in patients who developed reperfusion,so CT-1 and BNP maybe one of the reference markers to determine which patients who receive thrombolytic treatment will develop reperfusion.
出处
《中国实用医药》
2010年第9期19-21,共3页
China Practical Medicine
