摘要
本研究以循环内皮细胞（ＣＥＣ）作为血管内皮损伤的指示物，以血浆内皮素（ＥＴ－１）反映血管内皮的功能变化，研究了急性心肌梗塞（ＡＭＩ）患者内皮细胞的损伤和功能变化。４１例ＡＭＩ患者分为两组，Ａ组２６例，无梗塞后缺血事件及心力衰竭；Ｂ组１５例，有上述并发症。２１例健康人做为对照。动态测定患者在入院后７２小时的血浆ＥＴ－１水平和ＣＥＣ计数。结果显示：两组患者血浆ＥＴ－１和ＣＥＣ均在ＡＭＩ发病的早期４小时即达峰值，以后随时间推移而下降，但在７２小时内各测定值均高于正常对照组（Ｐ＜０．０１）。两组不同的是：具有合并症的ＡＭＩ患者（Ｂ组），其血浆ＥＴ－１水平和ＣＥＣ计数在各个时间点均高于Ａ组患者（Ｐ＜０．０１）；且随时间下降速度缓慢，在４８小时和７２小时仍呈较高水平，均高于Ａ组患者（Ｐ＜０．０１）；两组患者的ＥＴ－１和ＣＥＣ均呈显著的正相关（Ｐ＜０．００１）。结论：血浆ＥＴ－１水平和ＣＥＣ数量在ＡＭＩ早期显著增加，二者可做为心肌梗塞内皮细胞损伤和功能变化的指示物；在有并发症的ＡＭＩ中二者呈现持续升高，这可能与梗塞后缺血的发生和心脏功能减低有关。
This study aimed to investigate the endothelial dysfunction in acute myocardial infartion (AMI). Circulating endothelial cells (CEC) were used as an endothelial injury indicator and the plasma level of endothelin (ET1) as the functional marker of the vascular endothelial cells. 41 patients with AMI were divided into two groups: group A including 26 patients with uncomplicated AMI, group B with 15 patients with hemodynamic or ischemic sequelae. Results showed that the plasma ET1 levels in two groups rose sharply after the onset of chest pain and reached a peak level (P<0.01) at the 4th hour, the number of CEC showed a similar course of changes. However, patients in group B demonstrated the different dynamic changes in ET1 level and CEC number, which remained elevated at 48 hour and 72 hour, significantly different from values in group A in each time point (P<0.01). A significantly positive correlation was present between ET1 and CEC in both groups (P<0.001). It is concluded that the rapid increase in plasma ET1 and CEC may provide markers of endothelial perturbation in the early phase of AMI. The sustained increase in plasma ET1 and CEC in patients with complications of AMI may reflect continuous ischemia or marked depression of ventricular function.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
1997年第6期436-438,共3页
Chinese Journal of Cardiology
