Wu L
First Hospital, Beijing Medical University.
Zhonghua Xin Xue Guan Bing Za Zhi. 1992 Apr;20(2):90-2, 133-4.
Thirteen patients with totally silent myocardial ischemia (group 1) and 15 patients with effort angina (group 2) were studied. The coronary angiography of both groups indicated coronary artery stenosis > or = 50%. In group 1, the beta-endorphin plasma level (beta-EPL) during rest was significantly higher than those in group 2 (15.639 +/- 1.258 pg/ml and 8.920 +/- 1.478 pg/ml, respectively, P < 0.01). There were significant increases in beta-EPL in both groups after exercise as compared with that before exercise (beta-EPL is 33.801 +/- 6.243 pg ml/in group 1, P < 0.01; 18.169 +/- 3.540 pg/ml in group 2, P < 0.01). The difference between two groups after exercise was also significant (P < 0.05). The plasma level of noradrenaline (NE) during rest was 0.267 +/- 0.035 ng/ml, adrenaline (E) was 0.112 +/- 0.018 ng/ml in group 1, and NE was 0.218 +/- 0.032 ng/ml and E was 0.110 +/- 0.015 ng/ml in group 2. After exercise, NE was 1.017 +/- 0.160 ng/ml (P < 0.001), E 0.276 +/- 0.076 ng/ml (P < 0.001), E 0.260 +/- 0.043 ng/ml (P < 0.01) in group 2. There was no difference between two groups both in rest and after exercise (P > 0.05). This study indicates that the high plasma beta-endorphin level might play a major role in the occurrence of totally silent myocardial ischemia.
对13例完全无症状性心肌缺血患者(第1组)和15例劳力性心绞痛患者(第2组)进行了研究。两组的冠状动脉造影均显示冠状动脉狭窄≥50%。在第1组中,静息时血浆β-内啡肽水平(β-EPL)显著高于第2组(分别为15.639±1.258 pg/ml和8.920±1.478 pg/ml,P<0.01)。与运动前相比,两组运动后β-EPL均显著升高(第1组β-EPL为33.801±6.243 pg/ml,P<0.01;第2组为18.169±3.540 pg/ml,P<0.01)。运动后两组之间的差异也具有统计学意义(P<0.05)。第1组静息时去甲肾上腺素(NE)血浆水平为0.267±0.035 ng/ml,肾上腺素(E)为0.112±0.018 ng/ml;第2组NE为0.218±0.032 ng/ml,E为0.110±0.015 ng/ml。运动后,第2组NE为1.017±0.160 ng/ml(P<0.001),E为0.276±0.076 ng/ml(P<0.001),E为0.260±0.043 ng/ml(P<0.01)。两组在静息时和运动后均无差异(P>0.05)。本研究表明,血浆β-内啡肽水平升高可能在完全无症状性心肌缺血的发生中起主要作用。