冠心病患者血浆内皮素血栓素B_2和6-酮-前列腺素F_(1α)变化的临床研究

Clinical study on changes of endothelin,TXB_2 and 6-keto-PGF_(1α) in plasma of patients with coronary heart disease

目的 探讨内皮素(ET)、血栓素B2(TXB2)和6-酮-前列腺素F1α(6-keto-PGF1α)的变化在冠心病发病中的作用及临床意义。方法 采用放射免疫分析方法对不稳定性心绞痛(UA)组(n=23)、急性心肌梗死(AMI)组(n=20)、及正常对照组(n=20)血浆ET、TXB2和6-keto-PGF1α浓度同时进行测定。结果 UA组心绞痛发作期分别较终止后对照组、AMI组溶栓前分别较溶栓后及对照组ET和TXB2升高(P<001),6-keto-PGF1α降低(P<001和005);AMI组溶栓前ET和TXB2高于UA组心绞痛发作期(P<001),6-keto-PGF1α则无差异(P>005),AMI组溶栓后较UA组心绞痛终止后ET和6-keto-PGF1α无差异(P>005),UA组心绞痛终止后及AMI组溶栓后TXB2仍高于对照组(P<001),6-keto-PGF1α低于以照组(P<001和005),ET则无差异(P>005)。血浆ET浓度的升高与TXB2/6-keto-PGF1α比值呈正相关(AMI组:r=081P<001;UA组:r=068,P<001)结论 内皮素、TXB2/6-keto-PGF1α代谢失调导致了冠状动脉痉挛和血栓形成,三者共同参与了冠心病的发病,是诱发心绞痛的重要原因。内皮素和TXB2/6-keto-PGF1α可能通过相互作用加速UA向AMI的转化。

Objective To study the effect of endothelin(ET),thromboxane B 2(TXB 2)and 6-keto-PGF 1α on coronary heart disease (CHD).Methods Plasma ET,TXB 2 and 6-keto-PGF 1α concentrations were determined simutaneously in 23 patients with Unstable anging (UA),20 patients with acute myocardial infarction (AMI)and 20 healthy subjects by radioimmunoassay (RIA).Results The values of plasma ET,TXB 2 in the onset of UA patients were markedly higher than those post onset and in controls( P <0 01).The values of plasma ET,TXB 2 befor thrombolytic therapy in AMI patients were significantly higher than those after thrombolytic therapy in AMI patieuts and in controls( P <0.01),6-keto-PGF 1α were significantly reduced ( P <0 01 and 0.05),The values of plasma ET,TXB 2 befor thrombolytic therapy in AMI patients were markedly higher than those in the episode of UA patients ( P <0.01),but 6-keto-PGF 1α was no.differences occurred in the two group( P >0.05).Plasma ET,6-keto-PGF 1α concetrations after thrombolytic therapy of AMI group were no differences occurred than those post episode of UA group( P >0.05).Plasma TXB 2 concentrations post episode of UA group and after thrombolytic therapy of AMI group were still higher than the control group ( P <0.01),but 6-keto-PGF1 α was lower than the control group ( P <0.001 and 0.05).ET was no differences occurred ( P >0.05).Plasma ET concentrations of CHD displayed a positive correlation with the values TXB 2/6-keto-PGF 1α (AMI group:r=0.81 P <0.01,UA group:r=0.68, P <0.01).Conclusions Metabolism disorder of ET and TXB 2/6-keto-PGF 1α may lead to spasm of coronary artery.and thrombogenesis of coronary artery.The interaction between ET and TXB 2/6-keto-PGF 1α my be involved in the progress from UA to AMI. [