急性下肢动脉栓塞治疗前后血浆内皮素及降钙素基因相关肽水平的变化

Changes of Endothelin and Calcitonin Gene-Related Peptide in Patients UnderwentEmbolectomy and Thrombolysis

目的:探讨急性下肢动脉栓塞病人取栓加溶栓治疗前后,血浆内皮素(ET)和降钙素基因相关肽(CGRP)水平的变化与动脉栓塞后肢体缺血严重程度及栓塞时间、栓塞部位、预后情况的关系。方法:应用放射免疫法测定13例急性下肢动脉栓塞病人治疗前后7个时点及10例健康对照者血浆ET和CGRP水平的变化,并进行比较。结果:动脉栓塞组血浆ET水平自术中取栓后即明显下降,与术前比较差异显著(P<0.01)。术中溶栓后CGRP水平开始迅速上升,至术后2 h升至最高,与术前相比有显著意义(P<0.01)。术前血浆ET水平与肢体缺血严重程度呈正相关,CGRP水平与肢体缺血严重程度呈负相关。术后1～4 d血浆ET和CGRP水平与预后有相关性(P<0.01)。结论:急性下肢动脉栓塞病人取栓加溶栓治疗前血浆ET和CGRP水平与肢体缺血严重程度有相关性。术后连续监测血浆ET和CGRP水平有助于判断预后情况。

Objective: Our aim was to investigate changes of endothelin (ET) and calcitonin gene-related peptide ( CGRP) in patients with acute arterial embolism in lower extremities and its relationship with the degree , site , time of embolism,and the prognosis. Methods: We measured and compared the plasma levels of ET and CGRP in 13 patients with acute arterial embolism and 10 controls. Results:In the group of arterial embolism, the plasma level of ET decreased significantly after embolectomy compared with the level before the operation ( P < 0.01). The plasma level of CGRP increased significantly and reached the peak after thrombolysis compared with the level before the operation ( P < 0. 01). The ET levels before operation in patients had positive correlation with the degree of ischemia, and CGRP levels had negative correlation. The plasma levels of ET and CGRP in 1 to 4 days after operation had significant correlation with prognosis. Conclusion:Before operation, the levels of ET and CGRP had correlation with degree of limb ischemia. Monitoring the changes of ET and CGRP might be helpful in evaluating the prognosis.