Bagrov A Y, Kuznetsova E A, Fedorova O V
Division of Cardiology, I. I. Dzhanelidze Research Institute of Emergency Medicine, St Petersburg, Russian Federation.
J Intern Med. 1994 Jan;235(1):63-7. doi: 10.1111/j.1365-2796.1994.tb01033.x.
The aim of the study was to test the hypotheses that the concentrations of endogenous digoxin-like factor (EDLF) are (i) increased in the initial period after acute myocardial infarction (AMI) and (ii) may contribute to the genesis of ventricular arrhythmias.
Consecutive sample study.
An 800-bed city teaching hospital, primary hospitalized care centre.
Fifty-four consecutive patients of both sexes with a first transmural AMI, 16 male patients with unstable angina pectoris and eight healthy subjects.
None.
Time-course of the changes of plasma concentrations of EDLF (DELFIA digoxin fluoroimmunoassay) in patients during days 1-14 after uncomplicated AMI and AMI complicated with ventricular fibrillation and congestive heart failure.
Plasma concentrations of EDLF in patients on the 1st day after AMI were increased (1.25 +/- 0.26 ng ml-1 digoxin equivalents, P < 0.025) as compared with both healthy controls (0.34 +/- 0.06 ng ml-1) and patients with unstable angina pectoris (0.40 +/- 0.08 ng ml-1). On the 1st day after AMI the plasma levels of EDLF in seven patients with primary ventricular fibrillation were higher (2.54 +/- 0.67 ng ml-1, P < 0.05) than in 47 patients without ventricular fibrillation (1.05 +/- 0.27 ng ml-1). In 14 patients with AMI and congestive heart failure (class III, Killip), plasma concentrations of EDLF were significantly lower (0.32 +/- 0.09 ng ml-1, P < 0.01) than in 40 patients with AMI without congestive heart failure (1.51 +/- 0.32 ng ml-1). Starting from the 2nd day of AMI, plasma EDLF decreased to the level of the control values (0.35 +/- 0.04 ng ml-1) and did not change during a 2-week period of observation.
The results show an increase of plasma EDLF during the 1st day after AMI, and that higher plasma EDLF may be associated with the development of ventricular arrhythmias.
本研究旨在验证以下假设：（i）急性心肌梗死（AMI）后初期内源性地高辛样因子（EDLF）浓度升高；（ii）EDLF可能与室性心律失常的发生有关。
连续样本研究。
一家拥有800张床位的城市教学医院，主要住院护理中心。
54例连续的首次透壁性AMI患者，男女不限，16例不稳定型心绞痛男性患者和8名健康受试者。
无。
无并发症的AMI以及并发心室颤动和充血性心力衰竭的AMI患者在第1至14天血浆中EDLF浓度（DELFIA地高辛荧光免疫测定法）的变化时间过程。
AMI后第1天患者血浆EDLF浓度升高（1.25±0.26 ng/ml地高辛当量，P<0.025），与健康对照组（0.34±0.06 ng/ml）和不稳定型心绞痛患者（0.40±0.08 ng/ml）相比均升高。AMI后第1天，7例原发性心室颤动患者的血浆EDLF水平（2.54±0.67 ng/ml，P<0.05）高于47例无心室颤动患者（1.05±0.27 ng/ml）。14例AMI并发充血性心力衰竭（Killip III级）患者的血浆EDLF浓度（0.32±0.09 ng/ml，P<0.01）显著低于40例无充血性心力衰竭的AMI患者（1.51±0.32 ng/ml）。从AMI第2天开始，血浆EDLF降至对照值水平（0.35±0.04 ng/ml），并在2周观察期内未发生变化。
结果显示AMI后第1天血浆EDLF升高，且较高的血浆EDLF可能与室性心律失常的发生有关。
