不同部位心肌梗死急性期肾素血管紧张素醛固酮变化分析

摘要

目的:观察不同梗死部位急性心肌梗死(AMI)患者早期血浆中肾素(Renin)、血管紧张素Ⅱ(ATⅡ)、醛固酮(ALD)的变化.方法:将2015年至2016年入院治疗患者分为前壁AMI(49例)、下壁AMI(39例)、急性非ST段抬高型心肌梗死(NSTEMI)(29例)与不稳定性心绞痛(UA)组(53例),记录并比较各组血浆Renin、ATⅡ、ALD、脑钠肽(BNP)、左室舒张末期前后径(LV)、射血分数(EF)等.结果:前壁AMI组Renin16.73(8.42,33.12),下壁AMI组Renin18.98(8.30,30.41),NSTEMI组Renin15.27,均高于UA组Renin7.99(4.29,14.41),差异有统计学意义(P<0.01),而心肌梗死各组间Renin水平差异无统计学意义(P>0.05),各组间ATⅡ及ALD比较差异无统计学意义(P>0.05).Renin与ATⅡ具有相关性Rs=0.157(P<0.05),ALD与ATⅡ具有相关性Rs=0.325(P<0.01).结论:AMI早期Renin水平升高,不同部位心肌梗死Renin水平无差异,ATⅡ、ALD无升高,但Renin、ATⅡ、ALD之间有相关性.%Objective:To observe the changes of renin, angiotensin II ( ATII) and aldosterone ( ALD) in plasma of patients with acute myocardial infarction ( AMI) at different sites of infarction. Methods:A total of 49 patients with anterior wall AMI, 39 patients with inferior wall AMI, 29 patients with acute non-ST seg-ment elevation myocardial infarction ( NSTEMI) and 20 patients with unstable angina pectoris ( UA) were en-rolled in this study. (BNP), left ventricular end-diastolic diameter (LV), ejection fraction (EF) and so on were recorded and compared between the two groups. Results:Renin 16.73 (8.42, 33.12) in the anterior wall AMI group, Renin 18.98 (8.30,30.41) in the inferior wall AMI group and Renin 15.27 (P = 0.009) in the NSTEMI group were significantly higher than those in the UA group ( P <0.05) . There was no significant difference between the two groups (P> 0.05). There was no significant difference in the level of Renin be-tween the two groups ( P>0.05) . Renin and ATII were correlated with Rs = 0.157 ( P <0.05) . ALD was cor-related with ATII (Rs = 0.325, P <0.01). Conclusion:The level of Renin in the early stage of AMI was higher than that in the control group. There was no significant difference in the Renin level between the two groups. There was no significant difference in ATII and ALD between the two groups, but there was correlation between Renin, ATII and ALD.