急性心肌梗死患者血脂及内分泌因子的动态变化

Variation of blood lipids and circulatory endocrine factors in patients with acute myocardial infarction

观察 41例急性心肌梗死患者发病当日及发病第 3,7,14d血浆内皮素 (ET 1)、心房利尿肽 (ANP)、血清胰岛素浓度以及血清脂质水平。结果表明 :心肌梗死急性期血脂呈现以总胆固醇 (TC)与低密度脂蛋白胆固醇 (LDL C)降低、甘油三酯 (TG)升高为主的动态性改变 ;同时 ,内分泌因子ET 1,ANP和胰岛素也呈现动态性变化 ,并可能通过某些细胞因子影响血脂代谢。提示心肌梗死急性血脂呈特征性动态变化 ,对心肌梗死二级预防具有重要意义。

Objective: To observe the dynamic variations of blood lipids and circulatory endocrine factors in acute myocardial infarction(AMI) patients. Methods: We determined plasma levels of ET 1,ANP,insulin and serum lipids on the 1st, 3rd,7th and 14th day in 41 patients with acute myocardial infarction. Results: The serum levels of TC,LDL C obviously decreased from the 3rd to the 7th day, and gradually elevated on the 14th day. The serum level of TG elevated gradually and showed significant difference after one week. HDL C had no significant difference. The levels of ET 1 and insulin increased to highest level on the 1st day and decreased gradually since then. However, ANP reached the highest value on the 3rd day, and decreased markedly in fourteen days later. On the 1st day, only the concentration of insulin was negatively related with serum levels of TC,LDL C(r=-0.376,-0.388,respectively, P<0.05). The concentrations of blood lipids weren't related with circulatory endocrine factors during other phases. Conclusion: The primary characteristics of blood lipids dynamic variations are the decrement of TC,LDL C and the increment of TG during acute phase of AMI. Meanwhile, the concentrations of ET 1, ANP and insulin present dynamic variations and may effect the metabolism of blood lipids through some cytokines. [