新活素对急性心肌梗死患者内皮功能影响的临床研究

目的探讨急性心肌梗死患者在常规治疗的基础上加用新活素对血管内皮功能的影响。方法选择急性心肌梗死患者60例,随机分为实验组30例及对照组30例。对照组患者给予常规药物治疗,实验组患者在常规治疗基础上即刻静脉注射新活素。治疗前及治疗后2周超声观察肱动脉内皮依赖性舒张功能(FMD)的变化。2组分别在治疗前及治疗后2周采集静脉血,所有标本收集后统一检测。ELISA测定2组患者治疗前及治疗后血清NO及内皮素1含量。结果实验组治疗后FMD较对照组明显升高(15.09±1.13 vs 9.14±2.82,P<0.05);实验组治疗后血清NO含量较治疗前明显升高[(45.09±5.65)μmol/L vs(37.67±5.43)μmol/L,P<0.05],内皮素1含量较治疗前明显降低[(72.08±20.94)ng/L vs(84.56±23.83)ng/L,P<0.05];实验组治疗后血清NO含量较对照组明显升高,内皮素1含量较对照组明显降低。结论新活素能够通过增加血液中NO含量,降低内皮素1含量,改善急性心肌梗死患者的血管内皮功能,是其治疗急性心肌梗死的机制之一。

Effect of recombinant human brain natriuretic peptide on endothelial function in acute myocardial infarction patients

Objective To study the effect of recombinant human brain natriuretic peptide(rhBNP)on endothelial function in acute myocardial infarction patients.Methods Sixty acute myocardial infarction patients were randomly divided into experimental group and control group(30in each group).Patients in control group were treated with conventional drugs and those in experimental group were treated with conventional drugs plus intravenous rhBNP injection.Their brachial arterial endothelium-dependent diastolic function was detected by ultrasonography before and 2weeks after treatment.Venous blood samples were taken from the two groups before and 2weeks after treatment.Their serum nitric oxide(NO)and endothelin-1(ET-1)levels were measured by ELISA.Results The brachial arterial endothelium-dependent diastolic function was significantly better in experimental group than in control group after treatment(15.09±1.13 vs 9.14±2.82,P<0.05).The serum NO level was significantly higher while the serum ET-1level was significantly lower in experimental group after treatment than before treatment(P<0.05).The serum NO level was significantly higher while the serum ET-1level was significantly lower in experimental group than in control group after treatment(P<0.05).Conclusion rhBNP improves the endothelial function in acute myocardial infarction patients by increasing their serum NO level and decreasing their serum ET-level,which is one of the mechanisms underlying the treatment of acute myocardial infarction patients.