冠心病患者血浆神经降压素水平的变化及其临床意义

Changes in plasma neurotension level of patients with coronary heart disease and its clinical significance

目的 :研究不同类型冠心病患者发病不同阶段血浆神经降压素 (NT)水平的变化 ,探讨其与冠心病心肌缺血的关系。方法 :检测急性心肌梗塞 ,不稳定型心绞痛 ,稳定劳力型心绞痛 ,陈旧性心肌梗塞患者各 3 0余例发病不同阶段血浆NT浓度 ,并选 3 2例健康者作为对照组。结果 :急性心肌梗塞急性期 ( 2 4h) ,不稳定型心绞痛患者疼痛发作期血浆NT水平均明显高于对照组 ,稳定劳力型心绞痛患者 ,陈旧性心肌梗塞患者血浆NT水平与对照组比较差异无显著性。不稳定型心绞痛患者疼痛发作期血浆NT水平显著高于治疗 2周后病情稳定期 (P <0 0 1)。急性心肌梗塞患者血浆NT水平在心梗早期即有上升趋势 ,至 12h明显升高 ,2 4h达到高峰 [( 72 83± 14 3 4 )ng/L],4 8h后逐渐下降 ,72h后降至正常水平 [( 5 5 78± 11 80 )ng/L]。结论 :冠心病患者出现心肌急性缺血时 ,血浆NT水平升高 ,提示NT参与了冠心病患者急性心肌缺血时的病理生理过程。

AIM: To investigate the plasma neurotensin(NT) concentration in patients with coronary heart disease: acute myocardial infarction(AMI),unstable angina(UA),stable angina pectoris(SAP), old myocardial infarction (OMI), and to study the relationship between the plasma NT level and the myocardial ischemia . METHODS: The plasma NT concentration of 30 patients with AMI,32 patients with UA,35 patients with SAP, 31 patients with OMI and 32 normal controls were determined by radioimmunoassay(RIA). RESULTS: The plasma NT level in patients with AMI(24 h),in patients with UA when angina attacked is significantly higher than that of healthy controls. The plasma NT level in patients with SAP, in patients with OMI is not significantly different from that of healthy controls. The NT level of patients with UA when angina attacked is significantly higher than that after 2 weeks treatment (P<0.01). The NT level of AMI patients rose from early period and reached peak value at 24 h [(72.83±14.34) ng/L] .It began to decline at 48h,and restored to normal level at 72h. CONCLUSION: When acute myocardial ischemia occured in patients with coronary heart disease, the plasma NT level was elevated. This suggests NT may have participated in the pathophysiological course of myocardial ischemia.