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[血管加压素在急性心肌梗死中的临床意义]

[Vasopressin in acute myocardial infarct: clinical implications].

作者信息

Schaller M D, Nicod P, Nussberger J, Feihl F, Waeber B, Brunner H R, Perret C

出版信息

Schweiz Med Wochenschr. 1986 Dec 6;116(49):1727-9.

PMID:3810098
Abstract

Since current data on vasopressin (AVP) secretion during the early phase of myocardial infarction is not extensive, plasma AVP was measured in 26 patients with acute myocardial infarction. Twelve had an increased AVP concentration (23.2 +/- 7.0 pg/ml; mean +/- SEM) whereas 14 had an AVP level less than 3 pg/ml (1.96 +/- 0.14 pg/ml). The patients with AVP greater than 3 pg/ml had higher heart rate and plasma osmolality than those with AVP less than 3 pg/ml. Blood pressure values were the same in both groups of patients. There was no difference in peak CPK and iso CPK activities between the two groups. Seven patients with AVP greater than 3 pg/ml died within the next few days, while only 1 patient with AVP less than pg/ml died. It thus appears that increased AVP concentration during acute myocardial infarction is associated with a poor prognosis. Whether it is a cause or a consequence of an unfavourable course of myocardial infarction remains to be determined.

摘要

由于目前关于心肌梗死早期血管加压素(AVP)分泌的数据并不丰富,我们对26例急性心肌梗死患者的血浆AVP进行了测定。12例患者的AVP浓度升高(23.2±7.0 pg/ml;平均值±标准误),而14例患者的AVP水平低于3 pg/ml(1.96±0.14 pg/ml)。AVP大于3 pg/ml的患者心率和血浆渗透压高于AVP小于3 pg/ml的患者。两组患者的血压值相同。两组之间的肌酸磷酸激酶(CPK)峰值和同工酶CPK活性没有差异。7例AVP大于3 pg/ml的患者在接下来的几天内死亡,而只有1例AVP小于3 pg/ml的患者死亡。因此,急性心肌梗死期间AVP浓度升高似乎与预后不良有关。它是心肌梗死不良病程的原因还是结果仍有待确定。

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