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目的 探讨内皮素 (ET)、血栓素B2 (TXB2 )和 6 酮 前列腺素F1α( 6 keto PGF1α)在急性心肌梗塞 (AMI)溶栓治疗前后的变化及临床意义。方法 采用放射免疫分析方法对AMI组 (n =2 0 )及正常对照组 (n =2 0 )血浆ET、TXB2 和 6 keto PGF1α浓度分别于溶栓治疗前后进行测定。结果 AMI组溶栓前分别较溶栓后及对照组ET和TXB2升高 (P <0 0 1) ,6 keto PGF1α降低 (P <0 0 1和P <0 0 5 ) ,溶栓后TXB2 仍高于对照组 (P <0 0 1) ,6 keto PGF1α仍低于对照组 (P <0 0 5 ) ,ET则无统计学差异 (P >0 0 5 )。血浆ET浓度的升高与TXB2 6 keto PGF1α 比值呈正相关 (r =0 81,P <0 0 1)。结论 内皮素 ,TXB2 和 6 keto PGF1α代谢失调可加速AMI的发病。阻断ET分泌或拮抗ET的生理效应及恢复TXB2 6 keto PGF1α代谢平衡的措施有可能成为防治AMI发病的新途径
Objective To investigate the changes and clinical significance of endothelin (ET), thromboxane B2 (TXB2) and 6 keto PGF1α before and after thrombolysis in patients with acute myocardial infarction (AMI). Methods The levels of plasma ET, TXB2 and 6 keto PGF1α in AMI group (n = 20) and normal control group (n = 20) were measured by radioimmunoassay before and after thrombolysis. Results The levels of ET and TXB2 in the AMI group were significantly higher than those in the control group after thrombolytic therapy (P <0.01) and 6 keto PGF1α (P <0.01 and P <0.05), respectively Compared with the control group (P <0.01), 6 keto PGF1α was still lower than that of the control group (P <0.05), ET was not statistically different (P> 0.05). The increase of plasma ET concentration was positively correlated with the ratio of TXB2 6 keto PGF1α (r = 0 81, P 0 01). Conclusion The metabolic disorders of endothelin, TXB2 and 6 keto PGF1α may accelerate the onset of AMI. Blocking ET secretion or antagonizing the physiological effects of ET and restoring TXB2 6 keto PGF1α metabolic balance may become a new approach to the prevention and treatment of AMI