急性心肌梗塞过程中心房肽和脑钠素的变化.docVIP

急性心肌梗塞过程中心房肽和脑钠素的变化中国循环杂志 1999年第3期第14卷 冠心病研究专栏作者：林　杰　白小涓　李庭富关键词：心肌梗塞　脑钠素　心房肽　　摘要　目的：探讨急性心肌梗塞过程中血浆心房肽(ANP)、脑钠素(BNP)浓度的变化。方法：①用放射免疫法测定27例急性前壁心肌梗塞患者入院即刻、入院后第1天至第7天、第14天和第30天及60名对照者的血浆ANP、BNP浓度。②用放射性核素99m锝心血池扫描测定发病后7天及30天的左心室射血分数。结果：27例患者血浆ANP浓度仅于入院时、入院后第1天和第2天显著高于正常对照组(P＜0.01)，而BNP浓度则在所测各时间点均高于正常对照组(ANP、BNP的正常值分别为35.6±4.6 pg/ml和11.7±2.3 pg/ml)。血浆ANP浓度入院时已达到峰值，而血浆BNP的峰值在入院后第2天出现。血浆BNP浓度和与时间对应的左心室射血分数之间存在较密切的负相关(r=-0.52，P＜0.05；r=-0.65，P＜0.01)。结论：急性心肌梗塞后血浆ANP、BNP浓度显著升高且后者入院后出现峰值，心肌缺血损伤和收缩功能降低可能是引起血浆BNP浓度升高的原因之一。Changes of Plasma Levels of Atrial Natriuretic Peptide and Brain Natriuretic Peptide in the Course of Acute Myocardial Infarction Lin Jie,Bai Xiaojuan,Li Tingfu.　　Department of Cardiology,First Clinical Hospital of China Medical University,Shenyang (110001),Liaoning　　Abstract　Objective:To study the changes of plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) levels in the course of anterior acute myocardial infarction (AMI).Methods:①Plasma ANP and BNP concentrations of AMI patients (n=27) on admission,from the first day to the seventh day,fourteenth day,thirtieth day after admission and age-matched controls (n=60) were measured with radioimmunoassay.②Left ventricular ejection fraction was measured with 99mTc gated cardiac blood pool scintigraphy at the seventh day and thirtieth day after admission.Results:Both plasma ANP and BNP concentrations increased rapidly after AMI and the former were significantly higher (p＜0.01) than those of controls (ANP：35.6±4.6 pg/ml) on the first two days after admission while the latter were higher than controls (BNP:11.7?.3 pg/ml) on all the tested.ANP peaked on admission while plasma BNP concentrations increased rapidly reaching a peak on the 2nd day after admission.Plasma ANP concentrations had significant negative correlations with the time-matched left ventricular ejection fractions(r=-0.52，p＜0.05；r=-0.65，p＜0.01，respectively).Conclusion:Plasma ANP and BNP levels increased rapidly and significan