急性心肌梗塞、冠心病心绞痛、心力衰竭患者血浆内皮素的动态变化及其意义

用特异的放射免疫方法测定血浆内皮素（ＥＴ），对２３例急性心肌梗塞（ＡＭＩ）、２６例冠心病心绞痛及９例冠心病心力衰竭（ＣＨＦ）病人进行动态观察。发现该３组病人在治疗前血浆内皮素水平均显著高于对照组（Ｐ＜０．０１）。ＡＭＩ组１周后降至正常。心绞痛组在心绞痛发作时，血浆内皮素最高，随症状缓解，１周内降至正常。ＣＨＦ组血浆内皮素与心衰程度有关，心功能Ⅳ级组明显高于Ⅲ级组（Ｐ＜０．０１），随心衰缓解皆有所降低，但下降速度较缓慢。此外，血浆内皮素与心肌缺氧、缺血及心功能状态密切相关，可作为冠心病发生、发展衍变的重要依据，并可用于急性心梗后的动态观察，用以观察治疗效果及判断预后。

Plasma Endothelin Dynamic Change and Clinical Significance in AMI, Angina Pectoris and Heart Failure

Plasma endothelin (ET) with radioimmunoassay was messured respectively in AMI group (23 patients) angina pectoris group (26 patients) and coronary heart disease heart failure group(9 patients).ET in three groups was much higher than in control group.ET became normal one week after attack in AMI group.ET was highest in angina group at angina onset and returned to normal in one week as the symptoms relieved.ET was relevant to the degree of heart failure(HF).It was higher in Ⅳ grade HF than in Ⅲ grade HF and reduced with remission at a slower rate.ET was obvious higher in AMI group than in angina group.We consider that ET is correlated with myocardial ischemia , anoxia and cardiac function status.So ET can be used as the parameter of judging cardiac function status and assistant parameter of differiential diagnosis between AMI and angina.ET also can be used in dynamic observating on patients of post AMI and assesting the therapeutic effect and prognosis.