Somayajulu G L, Reddy P P
Department of Pathology, Osmania Medical College, Hyderabad.
Indian J Pathol Microbiol. 1996 Oct;39(4):271-5.
Tissue damage, inflammation and necrosis are hallmarks of myocardial infarction. In the present study significant elevations of serum alpha-1-antitrypsin were noted in coronary artery disease and angina cases. Interestingly chronic rheumatic heart disease which is also characterized by tissue injury. Inflammation revealed normal levels of serum alpha-1-antitrypsin. The level in chronic rheumatic heart disease was 3.37 +/- 0.57 mumol/mt/ml (control level was 3.37 +/- 0.54 mumol/mt/ml). The corollary of these observations is that in heart diseases acute phase response in terms of enhanced levels of alpha-1-antitrypsin differ depending on the causative factors. Except chronic rheumatic heart disease, in all other stressful states studied there is (to a certain degree) an altered systemic homeostasis and haemostasis. On the other hand chronic rheumatic heart disease encompass certain amount of acute phase status in terms of tissue damage and inflammation does exist unaccompanied by altered systemic homeostasis and haemostasis. However, bacteriological etiologies predominate the triggered immune responses. It is hypothesised that serum alpha-1-antitrypsin enhancement will not occur even though acute phase state exists if specific immune responses are also a part of the disease manifestation.
组织损伤、炎症和坏死是心肌梗死的特征。在本研究中，冠状动脉疾病和心绞痛病例的血清α-1-抗胰蛋白酶显著升高。有趣的是，同样以组织损伤为特征的慢性风湿性心脏病，炎症显示血清α-1-抗胰蛋白酶水平正常。慢性风湿性心脏病患者的水平为3.37±0.57μmol/mt/ml（对照水平为3.37±0.54μmol/mt/ml）。这些观察结果的推论是，在心脏病中，α-1-抗胰蛋白酶水平升高所反映的急性期反应因致病因素而异。除慢性风湿性心脏病外，在所研究的所有其他应激状态下，都存在（在一定程度上）系统性内环境稳态和止血功能的改变。另一方面，慢性风湿性心脏病在组织损伤和炎症方面确实存在一定程度的急性期状态，但不存在系统性内环境稳态和止血功能的改变。然而，细菌学病因在引发的免疫反应中占主导地位。据推测，如果特定的免疫反应也是疾病表现的一部分，即使存在急性期状态，血清α-1-抗胰蛋白酶也不会升高。
