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目的:探讨急性心肌梗死(AMI)患者溶栓前后血清神经肽Y(NPY)、一氧化氮(NO)、超氧化物歧化酶(SOD)、丙二醛(MDA)的含量变化及临床意义。方法:测定38例健康人和60例AMI患者溶栓前及溶栓后1、2、3、24、48和72h血清中NPY、NO、SOD和MDA的含量。结果:与健康人比较,溶栓前患者NPY和MDA含量升高,NO和SOD含量降低(P<0.05)。溶栓后1～3h的再通组与溶栓前及未通组比较,NPY和MDA含量更高,而NO和SOD含量更低(P<0.01)。再通组的NPY和MDA高峰出现在溶栓后2h,而NO和SOD的低谷恰好也出现在溶栓后2h。溶栓24h后再通组NPY和MDA含量下降,而NO和SOD含量升高(P<0.05),其变化幅度大于未通组(P<0.01)。结论:AMI后溶栓1～3h内NPY和MDA明显升高,NO和SOD明显下降,可能参与溶栓后早期内皮功能损伤。
Objective: To investigate the changes and clinical significance of serum neuropeptide Y (NPY), nitric oxide (NO), superoxide dismutase (SOD) and malondialdehyde (MDA) in patients with acute myocardial infarction (AMI) Methods: The levels of serum NPY, NO, SOD and MDA were measured in 38 healthy subjects and 60 AMI patients before thrombolysis and at 1, 2, 3, 24, 48 and 72 hours after thrombolysis. Results: Compared with healthy people, the levels of NPY and MDA increased and the levels of NO and SOD decreased (P <0.05). Compared with those before thrombolysis and before thrombolysis, the levels of NPY and MDA were higher in recanalization group 1 ~ 3h after thrombolysis, while the contents of NO and SOD were lower (P <0.01). The NPY and MDA peaks in the recanalization group appeared 2 h after thrombolysis, while the troughs of NO and SOD happened exactly 2 h after thrombolysis. After 24 hours of thrombolytic therapy, the levels of NPY and MDA decreased, while the contents of NO and SOD increased (P <0.05), and the changes were greater than that of the control group (P <0.01). CONCLUSION: After AMI, the levels of NPY and MDA are significantly increased within 1 ~ 3h after thrombolysis, and the levels of NO and SOD are significantly decreased, which may be involved in the early endothelial dysfunction after thrombolysis.