摘要
用动态心电图监测血液透析患者无症状心肌缺血（ＳＭＩ）发生情况，并同步观察其血浆精氨酸加压素（ＡＶＰ）及β－内啡肽（β－ＥＰ）含量。结果显示：血透病人缺血性ＳＴ段检出率为５２．３８％，其中ＳＭＩ占７２．７２％；透析前血浆ＡＶＰ浓度明显高于正常，透析后ＡＶＰ水平下降，但血浆β－ＥＰ在透析后则显著升高；并发现心绞痛发作病人透析前后其血浆β－ＥＰ浓度均低于ＳＭＩ患者。提示透析ＳＭＩ患者存在的“心绞痛报警系统”缺陷与透析中内源性阿片肽系统激活有关，血浆β－ＥＰ可能在ＳＭＩ发生中有一定作用。
n this study, we observed the incidence of silentmyocardial ischemia (SMI)
in 21 patients with chronicrenal failure (CRF) during hemodialysis (HD) by Hoter ECG
monitoring. The concentration of plasma argi-nine vasopressin (AVP) and β- endorphin (β-
EP)were determined by rneans of specific radioimmunoassay. The results showed that: (1) SMI
wasfound in 72. 720% patients with general myocardial is-chemia. (2) The concentration of
plasma AVP in pa-tients with CRF was significantly higher than that innormotensive subjects
(76. 73 ± 24.14 pg/ml P <0. 0l). The level of plasma AVP was obviously lowerthan that after
HD. (31 The level of plasma β- EPwas significantly higher than that before HD (267. 32+81.
68pg/ml, P<0. 05). It is suggested that thevariarion level of plasma β- EP between
precordialpain and SMI patients may account for the pain orpainless with rnyocardial ischemia.
The abnormal levelof plasma β- EP may play a role in the pathogenesis ofSMI.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
1994年第6期332-334,378,共4页
Chinese Journal of Nephrology
