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目的 :观察急性心肌梗死 (AMI)患者血浆中脑钠肽、内皮素、C -反应蛋白、心钠素水平变化 ,探讨AMI发病机制 ,为其诊断、治疗及预后判断提供依据。方法 :应用免疫放射分析及酶联免疫分析的方法对 4 6例AMI患者治疗前后和 30例正常对照者血浆中的BNP、ET、CRP、ANP水平进行检测。结果 :AMI患者血浆中BNP、ET、CRP、ANP治疗前后比较有显著性差异 (p <0 0 0 1 ) ,正常对照组与AMI治疗前比较有显著性差异 (p <0 0 0 1 ) ,BNP与CRP在AMI治疗前水平变化比较呈正相关 (r=0 874 ) ,治疗后呈明显的下降趋势其相关系数为(r=0 6 5 4 ) ,AMI治疗前后ANP与ET比较呈正相关 ,但AMI经溶栓和相应的支持治疗后ANP水平基本恢复到正常水平 (p >0 0 5 ) ,而BNP、ET、CRP水平虽然下降明显 ,但与正常组比较仍有明显差异 (p <0 0 5 )。结论 :AMI血浆中BNP、ANP、ET、CRP水平的变化说明其参与了急性心肌梗死发生、发展 ,特别是冠状动脉粥样斑块的形成和 (或 )破裂及血栓形成 ,其炎症因子是主要因素。因此 ,四项指标的观察分析对AMI诊断、治疗、预后判断具有重要意义。
Objective: To observe the changes of plasma brain natriuretic peptide, endothelin, C - reactive protein and atrial natriuretic peptide in patients with acute myocardial infarction (AMI) and to explore the pathogenesis of AMI and to provide basis for their diagnosis, treatment and prognosis. Methods: The levels of plasma BNP, ET, CRP and ANP in 46 AMI patients before and after treatment and 30 normal controls were detected by immune radioimmunoassay and enzyme-linked immunosorbent assay. Results: The levels of BNP, ET, CRP and ANP in plasma of AMI patients were significantly different before and after treatment (p <0.01 01). There was significant difference between the control group and AMI before treatment (p 0 01 0) There was a positive correlation between BNP and CRP levels before and after AMI (r = 0 874), and the correlation coefficient was significant (r = 0 6 5 4) after the treatment. There was a positive correlation between ANP and ET before and after AMI treatment The level of ANP in AMI recovered to normal level after thrombolytic therapy and corresponding supportive therapy (p> 0.05), while the levels of BNP, ET and CRP decreased significantly compared with those in normal group (p <0 0 5). Conclusion: The changes of BNP, ANP, ET and CRP levels in AMI plasma indicate that they are involved in the occurrence and development of acute myocardial infarction. In particular, the formation and / or rupture of coronary atherosclerotic plaques and thrombosis are the main inflammatory factors factor. Therefore, the four indicators of the observation and analysis of AMI diagnosis, treatment, prognosis of great significance.