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目的:探讨血浆内皮素(endothelin-ET)在急性脑卒中后心律失常发病机制中的作用。方法:用放射免疫法测定38例有明显心律失常脑卒中患者(心律失常组)和16例单纯急性脑卒中患者(单纯组),在急性期和恢复期血浆ET浓度,并测定15例同年龄组健康体检者的ET水平作为正常对照组。结果:急性期心律失常组血浆ET浓度显著高于单纯组(P<0。005),尤以脑出血(CH)者明显(与其他组比较P<0.05或<0.01)。恢复期心律失常组ET浓度仅稍高于单纯组,各组间比较已无显著性差异(P>0.05),但仍显著高于正常对照组。结论:心律失常组患者急性期存在显著的ET浓度异常升高,而过量的ET会导致冠状动脉舒缩功能障碍致痉挛,心肌功能及传导功能异常,推测ET在脑卒中后心律失常的发生机制中起重要的作用,心电图异常可能主要是由于神经体液调节紊乱所致。
Objective: To investigate the role of endothelin-ET in the pathogenesis of arrhythmia after acute stroke. Methods: Thirty-eight patients with arrhythmia stroke (arrhythmia group) and 16 patients with simple acute stroke (simple group) were measured by radioimmunoassay. Plasma ET concentrations in acute and convalescent phase were measured. Fifteen patients with the same age Group healthy subjects ET levels as a normal control group. Results: The plasma ET level in acute arrhythmia group was significantly higher than that in simple group (P <0.005), especially in those with cerebral hemorrhage (CHP) (P <0.05 or <0.01). ET concentration in convalescent arrhythmia group was only slightly higher than that in simple group, there was no significant difference between the groups (P> 0.05), but still higher than the normal control group. Conclusions: There is a significant abnormal increase of ET concentration in acute phase of arrhythmia patients. Excess ET may cause spasm, myocardial function and conduction dysfunction caused by coronary artery systolic and diastolic dysfunction. It is speculated that the mechanism of ET after stroke is arrhythmia Plays an important role in ECG abnormalities may be mainly due to neurohumoral regulation disorders.