Qiu S, Théroux P, Marcil M, Solymoss B C
Department of Medicine, Montreal Heart Institute, Quebec, Canada.
Cardiology. 1993;82(1):12-9. doi: 10.1159/000175848.
Plasma levels of endothelin-1 are elevated in acute myocardial infarction with higher levels in complicated infarctions. Measurements of levels in unstable angina could help clarify whether the elevation is the consequence of cell necrosis or is in some way related to the pathophysiology of acute coronary syndromes. Plasma endothelin-1 levels were determined by radioimmunoassay in 29 patients with unstable angina and 6 with a myocardial infarction. Blood samples were obtained at admission before drug administration and 6 and 72 h later. Levels were also determined in 27 control subjects and in 29 patients with stable angina. Admission levels were similar in unstable angina, 0.635 +/- 0.052 pg/ml [log(1 + x)], and myocardial infarction, 0.746 +/- 0.122, and significantly higher than in controls, 0.428 +/- 0.047, and stable angina patients, 0.449 +/- 0.052 (p < 0.01). In unstable angina, levels decreased progressively to normal at 6 h, 0.557 +/- 0.049 pg/ml, and 72 h 0.474 +/- 0.054, as opposed to an increase to 0.868 +/- 0.109 (p < 0.05) after 6 h in myocardial infarction followed by a decrease to 0.597 +/- 0.122 at 72 h. The elevation in unstable angina did not correlate with other clinical or laboratory characteristics. Unstable angina is associated with an increase in endothelin-1 plasma levels during the acute phase, suggesting a role of this endothelium-derived vasoactive peptide in the pathophysiology of acute coronary artery syndromes.
急性心肌梗死时血浆内皮素 - 1水平升高，复杂梗死时水平更高。测定不稳定型心绞痛患者的内皮素 - 1水平有助于明确其升高是细胞坏死的结果还是在某种程度上与急性冠状动脉综合征的病理生理学相关。采用放射免疫分析法测定了29例不稳定型心绞痛患者和6例心肌梗死患者的血浆内皮素 - 1水平。在入院时、给药前、给药后6小时和72小时采集血样。还测定了27名对照受试者和29例稳定型心绞痛患者的内皮素 - 1水平。不稳定型心绞痛患者入院时的水平为0.635±0.052 pg/ml [log(1 + x)]，心肌梗死患者为0.746±0.122，均显著高于对照组的0.428±0.047和稳定型心绞痛患者的0.449±0.052（p < 0.01）。在不稳定型心绞痛患者中，内皮素 - 1水平在6小时时逐渐降至正常，为0.557±0.049 pg/ml，72小时时为0.474±0.054；而在心肌梗死患者中，6小时后内皮素 - 1水平升高至0.868±0.109（p < 0.05），随后在72小时降至0.597±0.122。不稳定型心绞痛患者内皮素 - 1水平的升高与其他临床或实验室特征无关。不稳定型心绞痛在急性期与血浆内皮素 - 1水平升高相关，提示这种内皮源性血管活性肽在急性冠状动脉综合征的病理生理学中起作用。
