Joborn H, Hjemdahl P, Larsson P T, Lithell H, Lundin L, Wide L, Ljunghall S
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Chest. 1990 May;97(5):1098-105. doi: 10.1378/chest.97.5.1098.
Epinephrine has been shown to lower the plasma concentrations of several minerals and elevate those of parathyroid hormone (PTH). In order to evaluate the possible clinical importance of such experimental observations, 34 patients with acute myocardial infarction (AMI) were studied with daily determinations of plasma catecholamines, minerals, and PTH during the first week after AMI and at follow-up one month later. In addition, platelet catecholamines were determined as they fluctuate more slowly than plasma catecholamines. After infarction initial platelet epinephrine and norepinephrine levels were higher (p less than 0.05 for both) in nonsurvivors than survivors during a one year follow-up. Results suggested that activation of the sympathoadrenal system influences calcium homeostasis following AMI, but that the impact of sympathoadrenal activation on mineral metabolism is of minor clinical significance in the average AMI patient. High platelet catecholamine levels may predict a poor outcome after AMI.
肾上腺素已被证明可降低几种矿物质的血浆浓度,并升高甲状旁腺激素(PTH)的血浆浓度。为了评估此类实验观察结果可能具有的临床重要性,对34例急性心肌梗死(AMI)患者进行了研究,在AMI后的第一周以及一个月后的随访期间,每天测定血浆儿茶酚胺、矿物质和PTH。此外,由于血小板儿茶酚胺的波动比血浆儿茶酚胺更慢,所以也对其进行了测定。在一年的随访中,梗死发生后非幸存者的初始血小板肾上腺素和去甲肾上腺素水平高于幸存者(两者p均小于0.05)。结果表明,交感肾上腺系统的激活会影响AMI后的钙稳态,但交感肾上腺激活对矿物质代谢的影响在普通AMI患者中临床意义不大。高血小板儿茶酚胺水平可能预示着AMI后的不良预后。