缺血性心脏病患者血浆神经肽Y水平变化

Changes of Plasma Neuropeptide Y Levels in Patients with Ischemic Heart Disease

目的 :为探讨神经肽Y(NPY)缺血性心脏病发生、发展中的病理生理意义。方法 :95例缺血性心脏病患者包括心绞痛者 35例 (A组 )、急性心肌梗塞 (AMI)无心衰者 31例 (B组 )及AMI伴左心衰者 2 9例 (C组 ) ;分别于入院时与入院后 1、4、7及 2 8天测定了AMI患者血浆NPY的含量 ,心绞痛患者入院时与入院后 1天血浆NPY水平变化 ;同时测定了 37例正常人血浆NPY的含量。结果 :入院时患者血浆NPY水平均高于正常对照组 ,且病情越重升高越显著。A组 :1天后恢复至对照组水平。B组 :入院后 1天较入院时升高 ;入院后 4～ 7天逐渐降低 ,但仍高于对照组 ;2 8天后恢复至对照组水平。C组 :入院后 1、4天较入院时显著升高 ;其中 6例死亡患者入院后 4天极度升高 ;其余 2 3例入院后 7天开始下降 ,仍显著高于入院时的水平 ;入院后 2 8天较入院时明显降低 ,但仍明显高于对照组。结论 :血浆NPY含量测定对于缺血性心脏病患者病情观察及预后判定具有重要意义。

Objective To study the pathophysiological significance of neuropeptide Y(NPY) in ischemic heart disease (IHD). Methods The plasma NPY levels were measured by radioimmunoassay in 35 patients with angina pectoris (Group A), 31 patients with acute myocardial infarctions (AMI) without heart failure (Group B), 29 patients of AMI with left heart failure (Group C) and 27 normal subjects. Results The plasma NPY levels were higher in all these patients on admission than those in controls with the highest values in the most severe patients. The NPY levels in group A decreased to normal levels on day 1. In group B a significant increase in the levels of NPY was observed on day 1. Their NPY levels decreased significantly on days 4 and 7, but never to normal levels until day 28. Considerable increase in the levels of NPY were observed in group C on days 1 and 4. The levels of NPY were extremely high in six AMI patients with acute left heart failure before death. The NPY levels began to decrease on day 7 but never to their levels on admission until day 28; at that time the NPY levels were still higher than those in controls. Conclusion These informations indicated that plasma NPY might be useful for monitoring and predicting prognosis in patients with ischemic heart disease.