急性心肌梗死患者外周血管活性肽的动态观察

Dynamic changes in vasoactive peptides in peripheral blood in acute myocardial infarction patients

目的 :探讨血管活性肽在急性心肌梗死 (AMI)病理生理中的作用。方法 :采用化学比色法及放射免疫法测定 44例 AMI患者发病后即刻、第 1日、第 7日、第 14日和第 2 8日外周血肿瘤坏死因子 α(TNFα)、一氧化氮 (NO)、内皮素 (ET)、神经肽 Y(NPY)、神经降压素 (NT)及降钙素基因相关肽 (CGRP)水平。与另 40例健康体检者的血管活性肽水平作对照研究。结果 :在 AMI患者发病后即刻和第 1日的 TNFα、ET、NPY、CGRP水平均明显高于对照组 ,P<0 .0 1和 P<0 .0 0 1;而 NO、NT水平则明显低于对照组 (P均 <0 .0 1) ;TNFα与 ET、NPY、CGRP呈显著正相关 ,而与 NO、NT呈显著负相关。在 AMI发病后第 7日 ,TNFα、ET、NPY、CGRP水平逐渐下降 ,NO、NT水平逐渐升高 ,到第 2 8日上述变化仍未达到对照组水平。结论 :血管活性肽对 AMI的病理生理过程具有重要影响 ,并和

Objective:To study the role of vasoactive peptides in the pathophysiological process of acute myocardial infarction (AMI).Methods:Fortyfour patients were included in the study and blood of 40 healthy volunteers were collected as control.Peripheral blood samples were collected at the time of 0,1,7,14,and 28 days after AMI.Plasma levels of tumor necrosis factorα(TNFα),nitric oxide(NO),endothelin (ET),neuropeptide Y(NPY),neurotensin (NT),and calcitonin generelated peptide (CGRP) were assayed.Results:Plasma levels of TNFα,ET,NPY and CGRP increased significantly immediately and 1 day after the onset of AMI.There were significant positive correlation between the level of TNFα and ET,NPY,CGRP while significant negative correlation existed between the level of TNFα and NO,NT.The levels of the peptides and cytokines began to recover form 7 days after the AMI but they did not reach the normal level until 28 days after AMI.Conclusions:Vasoactive peptides participate in the pathophysiology of AMI,the levels of which are correlated with the severity of the disease.