急性心肌梗塞患者溶栓治疗前后若干血管活性物质的变化及临床意义

Changes and clinical significance of some vasoactivators before and after thrombolytic therapy in patients with acute myocardial infarction

目的 探讨内皮素 (ET)、血栓素B2 (TXB2 )和 6 酮 前列腺素F1α( 6 keto PGF1α)在急性心肌梗塞 (AMI)溶栓治疗前后的变化及临床意义。方法 采用放射免疫分析方法对AMI组 (n =2 0 )及正常对照组 (n =2 0 )血浆ET、TXB2 和 6 keto PGF1α浓度分别于溶栓治疗前后进行测定。结果 AMI组溶栓前分别较溶栓后及对照组ET和TXB2升高 (P <0 0 1) ,6 keto PGF1α降低 (P <0 0 1和P <0 0 5 ) ,溶栓后TXB2 仍高于对照组 (P <0 0 1) ,6 keto PGF1α仍低于对照组 (P <0 0 5 ) ,ET则无统计学差异 (P >0 0 5 )。血浆ET浓度的升高与TXB2 6 keto PGF1α 比值呈正相关 (r =0 81,P <0 0 1)。结论 内皮素 ,TXB2 和 6 keto PGF1α代谢失调可加速AMI的发病。阻断ET分泌或拮抗ET的生理效应及恢复TXB2 6 keto

Objective To study the changes of endothelin(ET),thromboxane B 2(TXB 2) and 6 keto PGF 1α before and after thrombolytic therapy in patients with acute myocardial infarction (AMI).Methods Plasma ET,TXB 2 and 6 keto PGF 1α concentrations were determined simultaneously in 20 patients with AMI and 20 healthy subjects by radioimmunoassay (RIA).Results The values of plasma ET and TXB 2 before thrombolytic therapy in AMI patients were markedly higher than those after thrombolytic therapy and in controls (both P <0.01).The values of plasma 6 keto PGF 1α were reduced ( P <0.01 and 0.05).Plasma TXB 2 concentration after thrombolytic therapy in AMI patients were still higher than those in control group ( P <0.01),the values of plasma 6 keto PGF 1α was lower than those in control group ( P <0.05),but ET was no differences occurred ( P >0.05).Plasma ET concentrations of AMI displayed a positive correlation with the values TXB 2/6 keto PGF 1α (r=0.81, P <0.01).Conclusion Metabolism disorder of ET,TXB 2 and 6 keto PGF 1α accelerate attack of AMI.Inhibiting secretion and effect of ET and restoring metabolism balance of TXB 2/6 keto PGF 1α may be a novel methods of preventing and curing AMI.