Domański L
Kliniki Chorób Wewnetrznych, Pomorskiej Akademii Medycznej w Szczecinie.
Ann Acad Med Stetin. 1999;45:137-55.
An increase in blood level of Cortisol and overproduction of free radicals is present during first days following acute ischemia and myocardial infarction. This increase exceeds the activity of protective compounds and systems of myocardial cells undergoing ischemia. The aim of this work was to study the relationship between the Cortisol blood level and the intensity of free radical reactions in patients with acute myocardial ischemia and acute myocardial infarction with respect to metabolic (glucose, uric acid) and enzymatic agents of ischemia and necrosis. The study was performed in 75 patients (20 females and 55 males) aged 38-75 years, including 13 patients with acute myocardial ischemia (6 females and 7 males) aged 40-66 years (group I), 40 patients with acute myocardial infarction (8 females and 32 males) aged 38-72 years (group II) and 22 healthy volunteers (6 females and 16 males) aged 39-75 years (control group). The concentration of Cortisol in blood and other biochemical determinants were measured on the second, fifth and seventh day following admission to the coronary care unit. The intensity of free radicals reactions was measured by using the concentration of Vitamin C, malondialdehyde (MDA), uric acid and white blood cells (WBC) count as markers. The results obtained have led to the following conclusions: 1. The increase in blood level of Cortisol in acute myocardial infarction is higher in comparison to the level of Cortisol in acute myocardial ischemia. 2. The intensity of free radical reactions during acute myocardial ischemia and acute myocardial infarction can be assessed by the decreased level of Vitamin C, increased level of malondialdehyde, uric acid concentration and leukocyte (WBC) count. 3. There is no correlation between the intensity of free radical reactions and elevation of blood cortisol during both acute myocardial ischemia and acute myocardial infarction. 4. Elevated levels of Cortisol in blood correlate with elevated levels of glucose and uric acid in blood during both acute myocardial ischemia and acute myocardial infarction. 5. Increase in enzymatic markers of ischemia and necrosis during acute myocardial ischemia and necrosis shows no correlation with the intensity of free radicals reactions.
在急性缺血和心肌梗死后的头几天，血液中皮质醇水平会升高，自由基产生过多。这种升高超过了经历缺血的心肌细胞中保护性化合物和系统的活性。这项研究的目的是，针对缺血和坏死的代谢（葡萄糖、尿酸）及酶学指标，研究急性心肌缺血和急性心肌梗死患者血液中皮质醇水平与自由基反应强度之间的关系。该研究纳入了75名年龄在38 - 75岁的患者（20名女性和55名男性），其中包括13名年龄在40 - 66岁的急性心肌缺血患者（6名女性和7名男性）（第一组）、40名年龄在38 - 72岁的急性心肌梗死患者（8名女性和32名男性）（第二组）以及22名年龄在39 - 75岁的健康志愿者（6名女性和16名男性）（对照组）。在进入冠心病监护病房后的第二天、第五天和第七天，测量血液中皮质醇的浓度以及其他生化指标。通过使用维生素C浓度、丙二醛（MDA）、尿酸和白细胞（WBC）计数作为标志物来测量自由基反应的强度。所得结果得出以下结论：1. 与急性心肌缺血患者的皮质醇水平相比，急性心肌梗死患者血液中皮质醇水平的升高幅度更大。2. 急性心肌缺血和急性心肌梗死期间自由基反应的强度可以通过维生素C水平降低、丙二醛水平升高、尿酸浓度和白细胞（WBC）计数来评估。3. 在急性心肌缺血和急性心肌梗死期间，自由基反应强度与血液皮质醇升高之间没有相关性。4. 在急性心肌缺血和急性心肌梗死期间，血液中皮质醇水平升高与血液中葡萄糖和尿酸水平升高相关。5. 急性心肌缺血和坏死期间缺血和坏死的酶学标志物升高与自由基反应强度无关。
