肝素涂层支架对冠心病患者纤溶、前列腺素及内皮素水平的影响及临床意义

目的研究冠心病患者肝素涂层支架植入术后纤溶、前列腺素、内皮素(ET)和丙二醛(MDA)水平的变化及临床意义。方法30例患者随机分为普通无涂层支架组(NCS)16例和肝素涂层支架组(HCS)14例,测定术前1、5和10min冠状静脉窦血浆ET和MDA;测定术前、术后不同时间点外周血浆ET,MDA、血栓素B(TXB2)、6-酮-前列腺素F1α(PGF1α)、组织型纤溶酶原激活物(t-PA)及其抑制物(PAI-1)的变化。结果NCS组:ET-1术后即刻和12h呈现大小两个高峰,MDA术后5min达高峰(P<0.01);HCS组:ET-1术后5、10min和12h明显低于NCS组(P值分别小于0.05、0.01和0.05),MDA术后5min至1d均明显低于NCS组;NCS和HCS组术后TXB2,PGF1α明显升高,术后24h达高峰;PAI-1术后无明显变化。结论冠状动脉内支架植入(ICS)术后确有血小板活化,纤溶活性变化不大,肝素涂层支架可降低术后ET-1和MDA水平,这可能对术后防止急性血管痉挛和(亚)急性血栓形成有一定保护作用。     

冠心病患者磁化支架后冠状窦血浆内皮素-1和凝血酶活性的变化

目的 观察经皮冠状动脉腔内成形术（PTCA）并磁化支架植入术（ICS）后冠状窦血浆的内皮素－1（ET－1）和凝血酶（Ⅱa)活性的动态变化。方法 住院冠心病患38例,随机植入磁化支架（MS）20例,非磁化支架（NMS）18例,分别于PTCA术前,ICS后,0．5,1,3和6h自冠状窦采血,观测血浆ET－1含量和Ⅱa活性。结果 术后MS组的ET－1含量一直处于较低水平,而NMS组在术后即刻明显升高（P＜0．01）,术后0．5开始下降,术后6h两组的ET－1含量均恢复到术前水平;MS组的Ⅱa活性于术后明显降低,术后6h较术前明显降低（P＜0．01）,而NMS组在术后即刻虽有降低,但在术后6h已恢复到术前水平。结论 磁化支架具有降低介入治疗术后冠状窦血浆ET－1含量和Ⅱa活性的作用。     

冠心病介入治疗术前、后血浆内皮素-1水平变化的研究

目的研究冠心病患者介入治疗术前、后血浆内皮素-1（ET-1）水平的变化。方法60例冠心病患者行经皮腔内冠状动脉成形术及即刻支架置入术（PTCA＆S），分别于PTCA前，PTCA后5min，支架置入后即刻（0min）、5min和10min采集外周静脉血，于术后12h，1d，3d，7d继续采集外周血，测试ET—1水平。结果PTCA术前、术后5min、支架置入后即刻（0min）、5min、10min和术后12h、1d、3d、7d患者血浆ET—1均值间差别有显著性意义（P〈0．05）；ET—1水平在支架置入后即刻和术后12h呈大小2个高峰（P〈0．05或〈0．01）。结论PTCA＆S术后ET—1呈2次释放高峰，可能与术后血管痉挛、血栓形成和心肌顿抑等有密切关系。     

冠状动脉内药物洗脱支架植入术后冠状静脉窦血中内皮素-1水平的变化

目的: 观察冠心病患者冠状动脉内支架安置术后冠状静脉窦血浆内皮素-1(ET-1)浓度的动态变化,探讨药物洗脱支架对术后再狭窄防治的作用机制.方法:冠心病患者42例,随机植入药物洗脱支架26例,普通支架16例,分别于冠状动脉球囊扩张术(PTCA)前、支架术后即刻、1 h、3 h和6 h自冠状静脉窦采血检测血浆ET-1的浓度.结果:药物洗脱支架组与普通支架组ET-1水平在术后即刻均降至最低点后即开始回升,到1 h时已超过术前水平,以后普通支架组ET-1水平继续升高,出现释放的第二峰.但药物洗脱支架组程度较为缓和,未出现明显的第二峰,2组ET-1水平在术后6 h差异有统计学意义(P<0.01).结论:药物洗脱支架可有效抑制冠状静脉窦血浆ET-1浓度的升高,可能是其防治再狭窄机制之一.     

急性胰腺炎早期脂质过氧化物与血管活性物质的变化

目的: 探讨内皮素(endothlin,ET)、降钙素基因相关肽(calcitonin gene-related peptide,CGRP)与脂质过氧化物(MDA)及自由基清除剂(SOD)在急性胰腺炎(AP)早期发病中的作用及临床意义.方法: 采用放射免疫分析法、硫代巴比妥酸法及黄嘌呤氧化酶法,分别测定急性发病期(24～48 h)重症急性胰腺炎(SAP)17例,轻症急性胰腺炎 (MAP)35例和正常对照组(NC)30例的血浆ET、CGRP和血清MDA及SOD的含量.结果: SAP组血浆ET水平明显增高,MAP明显降低(P＜0.001).SAP组血浆CGRP水平无明显变化(P＞0.05),MAP组明显增高(P＜0.001).AP患者血清MDA水平明显增高,而SOD明显降低,SAP与 MAP比较差异具有显著性(P＜0.01).SAP组ET/CGRP及MDA/SOD比值明显增高(P＜0.01),呈正相关(r值0.741 0,P＜0.01),MAP患者MDP/SOD比值明显增高(P＜0.01),ET/CGRP比值明显降低(P＜0.05).结论: AP早期可能以脂质过氧化损伤为主.ET/CGRP比例失调可能参与了SAP早期胰腺微循环障碍,与脂质过氧化物协同作用导致胰腺组织损伤.MDA/SOD及ET/CGRP比值反映胰腺病变的严重性,可作为判断AP预后的指标.     

依达拉奉对外伤性脑出血患者血浆ET,CGRP含量的影响及疗效观察

目的 观察依速拉奉对外伤性脑出血患者血浆内皮素(ET)、降钙素基因相关肽(CGRP)含量的影响,探讨依迭拉奉对外伤性脑出血患者的治疗效果.方法 收集神经外科脑出血患者160例,随机分为依远拉奉治疗组和常规治疗组,另取30例健康患者查血浆ET及CGRP作正常对照.用放射免疫测定法测定创伤性脑损伤患者血浆ET-1,CGRP的含量变化.结果 ①和正常组比较,外伤后血浆ET-1(1,3,5 d)明显升高(P＜0.01),CGRP明显下降(P＜0.01).②和常规组比较,依达拉奉治疗后血浆ET-1含量下降显著(P＜0.01),CGRP升高明显(P＜0.01).结论 依达拉奉可以显著降低ET-1血浆含量,提高CGRP水平,对外伤性脑出血患者有良好的治疗效果.     

吗啡对急性心肌梗死的保护作用

目的 研究吗啡对急性心肌梗死(AMI)梗死面积的影响和保护作用. 方法 43例AMI患者随机分为吗啡组(A组)23例和非吗啡组(B组)20例,15例健康体检者设为正常对照组(C组).A组入院即采静脉血后,立即注射吗啡3 mg,根据病情需要5-1 min后重复该计量,后于0.5 h,4 h,8 h,12 h,16 h,20 h,24 h采静脉血样,B组未用吗啡,所有样本查肌酸激酶同工酶(CK-MB)并取峰值,入院即刻和0.5 h血样测降钙素基因相关肽(CGRP)和内皮素-1(ET-1)浓度. 结果 A组与B组血浆CK-MB,CGRP,ET-1浓度明显高于C组(P＜0.01),入院时A组与B组CK-MB,CGRP和ET-1无明显差异(P＞0.05),0.5 h后A组CGRP显著高于B组(P＜0.01)亦高于入院时(P＜0.01),A组ET-1显著低于B组(P＜0.01)亦低于入院时(P＜0.01),A组CK-MB峰值显著低于B组(P＜0.01). 结论 吗啡能提高AMI患者血浆CGRP浓度,降低ET-1浓度,CK-MB浓度亦降低,因此有心肌保护作用.     

冠脉内磁化支架置入术后冠状静脉窦血中NO等物质水平变化

目的：研究冠心病患冠脉内置入磁化支架后冠状静脉窦血中一氧化氮（NO）氧化修饰低密度脂蛋白（oxLDL)、丙二醛（MDA）及超氧化物岐化酶（SOD）水平的变化，探讨磁化支架防治冠脉再狭窄作用的机制。方法：经皮腔内冠状动脉成形术及冠脉内支架置入术的冠心病患（25例）随机分为磁化支架组（17例）及非磁化支架对照组（8例）。经股静脉将右冠状动脉导管置入冠状静脉窦采血，采用Griess法等方法测定冠脉内支架置入术中及术后6h内冠状静脉窦血中NO，oxLDL,MDA及SOD的水平变化。结果：磁化支架组术后6h冠状静脉窦血中NO含量较对照组显升高（P＜0．01），而oxLDL和MDA与对照组相比降低（P＜0．05），P＜0．01），SOD与对照组相比升高（P＜0．01）。结论：NO升高与磁化支架预防冠脉再狭窄的作用相一致，其升高的机制与磁场清除自由基，增强抗氧化能力，使oxLDL生成减少的作用有关。     

原发性高血压血浆内皮素、降钙素基因相关肽改变及转换抑制剂对其影响

目的：了解原发性高血压病患者血浆内皮素（ET）,降钙素基因相关肽（CGRP,）浓度变化及培哚普利对血浆ET、CGRP浓度的影响。方法：对高血压病（EH）患者69例（轻中度分别为33、36例）应用放免法测定培哚普利治疗前后血浆ET、CGRP浓度变化,并与健康人做对照。结果：EH患者血浆ET水平较健康对照组显著增高（P＜0.01）,而CGRP水平较健康对照组显著降低（P＜0.01）。培哚普利治疗后二组患者的收缩压、舒张压都有显著下阵（P＜0.01）。随着血压的下降,血浆ET显著下降,而CGRP显著升高（P＜0.01）。结论：在培哚普利的降压作用中,有ET水平下降及CGRP升高因素参与,早期应用培哚普利可能有较好的血管内皮保护功能。     

2型糖尿病患者血浆内皮素及降钙素基因相关肽的研究

目的 探讨2型糖尿病（2－DM）患者合并视网膜病变（DR）和肾病（DN）时与内皮素（ET）和降钙素基因相关肽（CGRP）的关系。方法 应用免疫法测定了68例2－DM患者和28例正常对照者血浆ET和CGRP水平，并分析其相互关系。结果 2－DM患者血浆ET水平较对照组明显升高（P＜0．01），血浆CGRP水平较对照组明显降低（P＜0．01）。合并DR与合并DN组血浆ET水平均明显高于对照组及无并发症组，而血浆CGRP水平明显低于无并发症组及对照组。血浆ET与CGRP含量呈明显的负相关。结论 血浆ET及CGRP水平的变化可能同糖尿病的慢性微血管并发症的发生发展相关。     

川芎嗪对严重烧伤大鼠早期血浆CGRP/ET比值和cTnI含量变化的影响

目的研究严重烫伤大鼠早期心肌细胞损伤特异性指标cTnI与血浆CGRP/ET的比值变化之间的关系及川芎嗪对它们的调节作用。方法清洁级成年雄性Wistar大鼠104只,随机分为假烫组(A组),烫伤组(B组)和烫伤+川芎嗪治疗组(C组),A组8只;B、C两组各48只,B、C组又分为伤后1、3、6、12、24、48 h六个时相点,观察和检测血中CGRP、ET含量并计算CGRP/ET比值变化以及血浆cTnI含量变化。结果血液中CGRP/ET比值与A组比较B组伤后1 h即有下降,C组伤后3 h开始下降,两组比值在12 h达最低,以后逐渐有所回升,到48小时仍然明显低于正常(P< 0.05),但C组比值下降幅度低于B组(P<0.05)。与A组比较cTnI在B、C两组伤后1 h即有异常升高,到伤后6 h升高幅度明显加大,12 h达峰值分别为伤前的63和81倍,以后逐渐下降,到48 h两组尚未恢复到正常值(P<0.05),但C 组cTnI升高幅度低于B组(P<0.05)。结论烧伤早期血中CGRP/ET比值的降低与反映心肌细胞损伤指标cTnI的异常升高呈现明显的时间一致性,CGRP/ET引起的血管舒缩功能异常可能是导致心肌细胞损伤原因之一。川芎嗪可以通过改变CGRP/ET比值调节血管舒缩功能从而改善心肌供血起到保护严重烧伤早期心肌细胞功能的作用。     

地塞米松对家兔内毒素性脑损伤后神经肽表达的调节作用

目的　探讨地塞米松 (DXM)对家兔内毒素性脑损伤后降钙素基因相关肽 (CGRP)、内皮素 (ET)、心房利钠肽 (ANP)、血管紧张素Ⅱ (AⅡ )等 4种神经肽表达及脑水肿的影响。方法　 6 5只新西兰白兔分为内毒素组 (A组 )、内毒素 +DXM组 (B组 )和生理盐水对照组 (C组 ) ,每组 5只。A组于脑池内注射内毒素 10 0 μg/kg体重 ,B组注射内毒素 10 0 μg/kg+DXM 1mg/kg。于注射后 3h、6h、12h、2 4h、48h、72h同时收集血液、脑脊液 (CSF) ,并处死家兔留取脑组织 (海马区 )。放射免疫法测定神经肽含量 ,干燥法测定脑含水量。结果　注射内毒素或内毒素 +DXM后 3～ 72h ,血浆、CSF和脑组织 4种神经肽均呈现时相性显著变化 ,以 12～ 2 4h左右最明显 (P <0 .0 5或P <0 .0 1)。B组神经肽变化幅度均显著低于A组 (P <0 .0 5或P <0 .0 1)。脑组织含水量明显升高 ,2 4h为高峰 ,B组低于A组 (P <0 0 5或P <0 0 1)。结论　在内毒素诱导下 ,CGRP、ET、ANP、AⅡ呈时相性变化并与脑水肿有关。DXM可调控神经肽的变化并减轻脑水肿。     

急性心肌梗死患者血浆ET、CGRP的动态变化及临床意义

目的:探讨内皮素、降钙素基因相关肽在急性心肌梗死发病中的临床意义。方法:应用放免法同步动态测定急性心肌梗死(AMI)组(n=44)、正常对照组(n=38)的血浆ET、CGRP的浓度水平。结果:AMI组即刻、第1d、第7d ET、CCRP均明显高于AMI恢复期和正常对照组;但ET/CGRP比值明显降低,且ET与CGRP呈显著正相关。至第14d ET、CGRP明显下降,均具有统计学意义。结论:ET与CGRP的动态变化对急性心肌梗死的病理生理过程具有重要的影响。     

Effects of Xin Mai Tong Capsule on Vasoregulatory Peptides in the Patients of Coronary Heart Disease

In order to inquire into the therapeutic effects of Xin Mai Tong Capsule(心脉通胶囊)on coronaryheart disease with myocardial ischemia,40 patients were randomly divided into two groups(Xin MaiTong group and the control group).The plasma endothelin(ET)levels in the two groups of patientswere markedly higher than that of the healthy people(P<0.001),and the calcitonin gene relatedpeptide(CGRP)was similar to that of the healthy people(P>0.05).After treatment,ET andsymptomatic scores in the two groups decreased markedly(P<0.01),and their S-T segments wereelevated obviously(P<0.01).But the decrease of ET and symptomatic scores and elevation of S-Tsegment in Xin Mai Tong group were superior to those of the control group(P<0.05~0.01).TheCGRP level in the control group did not vary obviously post-treatment,but it increased markedly(P<0.01)with the addition of Xin Mai Tong Capsule in Xin Mai Tong group.     

Clinical study on protective effect of Xinmaitong capsule on damage of vascular endothelial cellson damage of vascular endothelial cells

Objective: To assess the effect of Xinmaitong (XMT) capsule in treating coronary heart disease (CHD).Methods: The 38 patients of coronary heart disease with myocardial ischemia were divided randomly into XMT group (20 cases) and control group (18 cases). Conventional western medical therapy was given to both groups and the XMT group received XMT treatment in addition. The changes of endothelin (ET) and calcitonin gene-related peptide (CGRP) levels, ST segment of ECG and clinical symptoms after treatment in all the patients were observed. 14 healthy persons were taken as normal control.Results: The ET level of all patients was significantly higher than that of normal control (P < 0. 001), and level of CGRP in patients was not significantly different from normal (P > 0. 05). After treatment, results showed that: (1) The ET levels and the scores of clinical symptoms of both groups decreased significantly (P < 0. 01), and the depressed ST segment elevated markedly (P < 0.01) as compared with that before treatment, and the changes revealed more evidently in XMT group in comparison with those in the control group (P < 0. 05~0. 01). (2) The level of CGRP was significantly increased in XMT group (P < 0. 01) while it was unchanged in the control group (P > 0. 05).Conclusion: Thereis a severs damage of vascular endothelial cells (VEC) in patients of coronary heart disease. XMT could not only reduce significantly the plasma ET content, but also enhance markesdly the production and release of CGRP, so it has a good anti-ischemic effect, which may be closely correlated with its action on improving the function of VEC and regulating metabolism of ET and CGRP.     

Relationship among plasma endothelin, calcitonin gene-related peptide and blood flow rate of bilateral vertebral arteries in patients with cervical vertigo

Objective: To investigate the relationship among plasma endothelin(ET), calcitonin gene-related peptide(CGRP) and blood flow rate of bilateral vertebral arteries in patients with cervical vertigo(CV) and to assess the effect of ET and CGRP on the onset of CV. Methods:The concentration of ET and CGRP in 64 patients with CV and 30 controls was determined by radioimmunity method. The average blood flow velocity (Vm) of bilateral vertebral arteries was detected by Transcranial Doppler(TCD). Results:Plasma concen- tration of ET(91.48± 9.08 pg/ml) and ET/CGRP ratio value(2.88± 0.52) in vertebrobasilar arteriospasm group were both higher than those in vertebrobasilar non-arteriospasm group and in controls, while CGRP concentration(30.66± 6.05 pg/ml) in vertebrobasilar arteriospasm group was lower than that in vertebrobasilar non-arteriospasm group and controls respectively. The Vm of bilateral verte- bral arteries in vertebrobasilar arteriospasm group(67.97± 11.64 cm/s ) was higher than that in vertebrobasilar non-arteriospasm group and controls respectively, having a positive correlation with ET concentration and ET/CGRP ratio value(r1=0.52, P < 0.05; r2=0.59, P < 0.05), but a negative correlation with CGRP concentration(r3=-0.54, P < 0.05). There was no significant difference in ET and CGRP concentration, ET/CGRP ratio value and the Vm of bilateral vertebral arteries between vertebrobasilar non-arteriospasm group and the control group. Conclusion: All the results indicate that ET and CGRP are possibly the most important substance factors at the onset of CV with vertebrobasilar arteriospasm, and their imbalance of regulating vertebrobasilar arterial contraction and relaxation may play an important role in the onset of CV with vertebrobasilar arteriospasm.     

硝酸甘油对充血性心力衰竭患者血浆降钙素基因相关肽和内皮素的影响

OBJECTIVE: To investigate the plasma calcitonin gene-related peptide (CGRP) and endothelin (ET) levels and the effects of nitroglycerin on CGRP and ET in congestive heart failure (CHF), and to make clear the mechanism of nitroglycerin in vasodilation and cardiac protection. METHODS: The fast blood samples were taken from the peripheral vein of 40 volunteers and 40 CHF patients to estimate the basal level of CGRP and ET. Infusion of nitroglycerin of 25 to 50 micrograms/min started in the forearm vein of CHF patients. Blood samples were taken at the end of the 1 hour infusion and (12 +/- 2) days of nitroglycerin treatment. Plasma concentrations of CGRP and ET were measured by radioimmunoassay. RESULTS: In patients with CHF before the treatment, the plasma concentration of CGRP was significantly lower than that in the controls (P < 0.001), but the concentration of ET significantly higher than that in the controls (P < 0.001). During the nitroglycerin treatment, the plasma concentration of CGRP significantly increased (P < 0.001), whereas the concentration of ET significantly decreased (P < 0.01). The mean arterial pressure significantly decreased (P < 0.001). CONCLUSION: Nitroglycerin can increase the peripheral plasma CGRP level and decrease the concentration of ET when treating CHF. Intravenous nitroglycerin may be beneficial to the improvement of abnormal haemodynamics and neurohormonal derangement.     

硝酸甘油对充血性心力衰竭患者血浆降钙素基因相关肽和内皮素的影响

目的 :研究充血性心力衰竭 (CHF)患者血浆降钙素基因相关肽 (CGRP)和内皮素 (ET)的水平以及硝酸甘油的影响 ,探讨硝酸甘油的扩血管和心脏保护机制。方法 :用放射免疫法测定了 4 0例正常人和 4 0例CHF患者外周静脉血浆中CGRP和ET的基础值 ;给予CHF患者以硝酸甘油 2 5～ 5 0 μg /min静脉滴注治疗 ,并在治疗后不同时间采血测CGRP和ET的浓度。结果 :①与对照组相比 ,治疗前CHF患者血浆CGRP浓度明显降低 (P <0 .0 0 1 ) ,ET 1浓度明显增高 (P <0 .0 0 1 ) ;②CHF患者治疗后CGRP浓度升高 (P <0 .0 0 1 ) ,而ET的浓度下降 (P<0 .0 0 1 ) ,伴随有平均动脉压 (MAP)的明显降低 (P <0 .0 0 1 )。结论 :硝酸甘油治疗CHF能促进CGRP的释放 ,不仅可改善血流动力学异常 ,而且可改善神经内分泌的失衡 ,对心脏有保护作用     

急性重型颅脑损伤ET和CGRP含量变化及其临床意义

目的　探讨急性重型颅脑损伤 (ASBI)患者血浆中内皮素 (ET)和降钙素基因相关肽 (CGRP)的含量变化及其临床意义。方法　用放免法测定 2 8例ASBI患者伤后 6～ 2 4h血浆中ET及CGRP含量。结果　ASBI患者ET含量明显增多 ,差别有显著性 (P <0 .0 5 ) ;CGRP也有一定的增多 ,但无显著性差异。结论　ET和CGRP共同参与ASBI病理生理反应过程 ,ET释放增加是加重脑继发性损害的重要因素     

辛伐他汀对68例冠心病心力衰竭患者血管内皮功能的影响

目的：研究辛伐他汀（舒降之）对冠心病（CHD）合并充血性心力衰竭（CHF）患者血浆中一氧化氮（NO）、降钙素基因相关肽（CGRP）和内皮素（ET）的影响。方法,68例CHD并CHF患者随机分为两组，常规用药（对照）组（地高辛、氢氯噻嗪、硝酸异山梨酯）34例，常规用药加辛伐他汀（联用）组34例，并附正常人组34例。NO测定用Greiss法，放射性免疫法测定治疗前后血中CGRP和ET的水平。结果：CHD并CHF患者中NO和CGRP水平明显低于正常人组（P〈0．01），ET显著高于正常人组（P〈0．01），治疗后均显著改善（P〈0．01），且以常规用药加辛伐他汀组改善更为显著，与常规组治疗后比较P〈0.05。结论：常规用药加辛伐他汀能显著改善CHD合并CHF患者的NO、CGRP和ET的代谢失衡。