左卡尼汀對(duì)老年非ST段抬高型心肌梗死患者內(nèi)皮素和腦鈉肽水平的影響
發(fā)布時(shí)間：2018-12-29 18:58
【摘要】：目的:急性冠脈綜合征(acute coronary syndrome,ACS)包括不穩(wěn)定型心絞痛(unstable angina,UA)、非ST段抬高型心肌梗死(non-ST-elevated myocardial infarction,NSTEMI)和ST段抬高型心肌梗死(ST-elevated myocardial infarction,STEMI),臨床上對(duì)于ACS的生化診斷標(biāo)志物已經(jīng)進(jìn)行了大量的研究。本文主要探討左卡尼汀對(duì)老年NSTEMI患者內(nèi)皮素(Endothelin-1,ET-1)和腦鈉肽(brain natriuretic peptide,BNP)水平的影響,旨在為NSTEMI的診治提供新的理論依據(jù)。方法:選擇2013-10~2014-08在發(fā)病后6小時(shí)內(nèi)入住承德市中心醫(yī)院老年病科和心內(nèi)科、入院后確診為NSTEMI的年齡大于60歲的患者60例作為治療組,隨機(jī)分為左卡尼汀組(A組)和常規(guī)治療組(B組),所有患者入院后即刻及入院后分別在發(fā)病6h、12h、24h、3d、7d、14d六個(gè)時(shí)段均留取血標(biāo)本測(cè)定血清ET-1及BNP水平。選擇承德市中心醫(yī)院健康體檢中心體檢健康的60周歲以上老年人30例作為對(duì)照組。抽取空腹血標(biāo)本測(cè)定血清ET-1及BNP水平。對(duì)三組之間ET-1和BNP水平進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:血清BNP、ET-1水平的組間比較:左卡尼汀組、常規(guī)治療組和對(duì)照組三組相比,血清BNP水平和ET-1水平在每一個(gè)時(shí)間點(diǎn)各組間均有明顯差異(各P值均0.05),且表現(xiàn)為常規(guī)治療組左卡尼汀組對(duì)照組的大小關(guān)系。血清BNP、ET-1水平的動(dòng)態(tài)變化:(1)血清BNP水平的動(dòng)態(tài)變化:常規(guī)治療組患者血清BNP呈雙峰分泌,第一峰峰值高于左卡尼汀組,出現(xiàn)時(shí)間為12.50±0.70h,第二峰出現(xiàn)時(shí)間為156.60±7.34h。而左卡尼汀組血清BNP濃度只有一個(gè)峰值,出現(xiàn)時(shí)間為15.84±0.98h。(2)血清ET-1水平的動(dòng)態(tài)變化:左卡尼汀組和常規(guī)治療組血清ET-1水平動(dòng)態(tài)變化均存在一個(gè)峰值。常規(guī)治療組峰值較高,其出現(xiàn)時(shí)間7.90±0.21h。左卡尼汀組峰值出現(xiàn)時(shí)間為16.70±1.30h。結(jié)論:1左卡尼汀組及常規(guī)治療組患者血清BNP水平和ET-1水平均高于對(duì)照組,說(shuō)明在NSTEMI后病情演變過(guò)程中存在血清BNP、ET-1水平的升高。2左卡尼汀組患者血清BNP水平和ET-1水平低于常規(guī)治療組,說(shuō)明左卡尼汀能降低NSTEMI患者血清BNP、ET-1升高程度。3根據(jù)血清BNP及ET1水平的變化,說(shuō)明應(yīng)用左卡尼汀治療可使NSTEMI患者ET-1、BNP水平降低,說(shuō)明左卡尼汀對(duì)NSTEMI發(fā)病后神經(jīng)內(nèi)分泌激活有抑制作用,此作用有利于患者恢復(fù)。
[Abstract]:Objective: acute coronary syndrome (acute coronary syndrome,ACS) includes unstable angina pectoris (unstable angina,UA), non-ST segment elevation myocardial infarction (non-ST-elevated myocardial infarction,NSTEMI) and ST segment elevation myocardial infarction (ST-elevated myocardial infarction,STEMI). A great deal of research has been done on the biochemical diagnostic markers of ACS. The effect of levacarnitine on the levels of endothelin (Endothelin-1,ET-1) and brain natriuretic peptide (brain natriuretic peptide,BNP) in elderly patients with NSTEMI was studied in order to provide a new theoretical basis for the diagnosis and treatment of NSTEMI. Methods: sixty patients with NSTEMI over 60 years old who were admitted to Department of Geriatrics and Cardiology in Chengde Central Hospital within 6 hours after onset were selected as treatment group. The patients were randomly divided into two groups: group A (group A) and group B (routine therapy). The serum ET-1 and BNP levels were measured immediately after admission and at 6 hours after the onset of the disease. Thirty elderly people over 60 years of age were selected as control group. Serum levels of ET-1 and BNP were measured in fasting blood samples. The levels of ET-1 and BNP in the three groups were analyzed statistically. Results: compared with the control group, the serum BNP and ET-1 levels in the Levocarnitine group, the routine treatment group and the control group were significantly different at each time point (P < 0. 05). The relationship between the size of the control group and the levocarnitine group in the routine treatment group was also presented. Dynamic changes of serum BNP,ET-1 level: (1) dynamic changes of serum BNP level: the serum BNP secretion of patients in routine treatment group was double peak, the first peak value was higher than that of levocarnitine group, the time of occurrence was 12.50 鹵0.70 h. The time of the second peak was 156.60 鹵7.34 h. However, there was only one peak value of serum BNP in levocarnitine group (15.84 鹵0.98 h). (2) the dynamic change of serum ET-1 level: there was a peak value of serum ET-1 level in levocarnitine group and routine treatment group. The peak value of routine treatment group was higher, the time of occurrence was 7.90 鹵0.21 h. The peak time of L-carnitine group was 16.70 鹵1.30 h. Conclusion: 1 the serum BNP and ET-1 levels of patients in levocarnitine group and routine treatment group are higher than those in control group, indicating the presence of serum BNP, in the course of disease development after NSTEMI. The level of serum BNP and ET-1 in levocarnitine group was lower than that in routine treatment group, which indicated that levocarnitine could decrease the increase of serum BNP,ET-1 in NSTEMI patients. 3 according to the changes of serum BNP and ET1 levels, levocarnitine could decrease the level of serum BNP,ET-1 in patients with NSTEMI. The results suggest that levacarnitine can decrease the level of ET-1,BNP in patients with NSTEMI, and that levocarnitine can inhibit the neuroendocrine activation after the onset of NSTEMI, which is beneficial to the recovery of patients with NSTEMI.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R542.22
本文編號(hào)：2395254
[Abstract]:Objective: acute coronary syndrome (acute coronary syndrome,ACS) includes unstable angina pectoris (unstable angina,UA), non-ST segment elevation myocardial infarction (non-ST-elevated myocardial infarction,NSTEMI) and ST segment elevation myocardial infarction (ST-elevated myocardial infarction,STEMI). A great deal of research has been done on the biochemical diagnostic markers of ACS. The effect of levacarnitine on the levels of endothelin (Endothelin-1,ET-1) and brain natriuretic peptide (brain natriuretic peptide,BNP) in elderly patients with NSTEMI was studied in order to provide a new theoretical basis for the diagnosis and treatment of NSTEMI. Methods: sixty patients with NSTEMI over 60 years old who were admitted to Department of Geriatrics and Cardiology in Chengde Central Hospital within 6 hours after onset were selected as treatment group. The patients were randomly divided into two groups: group A (group A) and group B (routine therapy). The serum ET-1 and BNP levels were measured immediately after admission and at 6 hours after the onset of the disease. Thirty elderly people over 60 years of age were selected as control group. Serum levels of ET-1 and BNP were measured in fasting blood samples. The levels of ET-1 and BNP in the three groups were analyzed statistically. Results: compared with the control group, the serum BNP and ET-1 levels in the Levocarnitine group, the routine treatment group and the control group were significantly different at each time point (P < 0. 05). The relationship between the size of the control group and the levocarnitine group in the routine treatment group was also presented. Dynamic changes of serum BNP,ET-1 level: (1) dynamic changes of serum BNP level: the serum BNP secretion of patients in routine treatment group was double peak, the first peak value was higher than that of levocarnitine group, the time of occurrence was 12.50 鹵0.70 h. The time of the second peak was 156.60 鹵7.34 h. However, there was only one peak value of serum BNP in levocarnitine group (15.84 鹵0.98 h). (2) the dynamic change of serum ET-1 level: there was a peak value of serum ET-1 level in levocarnitine group and routine treatment group. The peak value of routine treatment group was higher, the time of occurrence was 7.90 鹵0.21 h. The peak time of L-carnitine group was 16.70 鹵1.30 h. Conclusion: 1 the serum BNP and ET-1 levels of patients in levocarnitine group and routine treatment group are higher than those in control group, indicating the presence of serum BNP, in the course of disease development after NSTEMI. The level of serum BNP and ET-1 in levocarnitine group was lower than that in routine treatment group, which indicated that levocarnitine could decrease the increase of serum BNP,ET-1 in NSTEMI patients. 3 according to the changes of serum BNP and ET1 levels, levocarnitine could decrease the level of serum BNP,ET-1 in patients with NSTEMI. The results suggest that levacarnitine can decrease the level of ET-1,BNP in patients with NSTEMI, and that levocarnitine can inhibit the neuroendocrine activation after the onset of NSTEMI, which is beneficial to the recovery of patients with NSTEMI.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R542.22
【引證文獻(xiàn)】
相關(guān)期刊論文 前1條
1 任春萍;孫春艷;施保環(huán);;左卡尼汀治療老年非ST段抬高型心肌梗死的效果[J];實(shí)用臨床醫(yī)藥雜志;2016年05期
，本文編號(hào)：2395254
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