摘要
目的：探讨心肌内源性阿片肽（ＥＯＰ）的变化和对术前心功能的影响及其可能的机制。方法：应用放射免疫法测定２１例风湿性二尖瓣病变患者心肌中β－内啡肽（β－ＥＰ）、亮脑啡肽（Ｌｅｕ－ＥＮＫ）和强啡肽Ａ１－１３（ＤｙｎＡ１－１３）以及ｃＡＭＰ和ｃＧＭＰ含量。结果：风心病二尖瓣狭窄组（ＭＳ组）、二尖瓣关闭不全组（ＭＩ组）心肌β－ＥＰ、Ｌｅｕ－ＥＮＫ和ＤｙｎＡ１－１３含量均显著高于正常对照组（Ｐ＜０．０１）；ＭＩ组心肌β－ＥＰ、Ｌｅｕ－ＥＮＫ含量显著高于ＭＳ组（Ｐ＜０．０５），ＤｙｎＡ１－１３含量在ＭＩ和ＭＳ两组间无统计学差异（Ｐ＞０．０５）；风心病ＭＳ和ＭＩ组心肌ｃＡＭＰ含量及ｃＡＭＰ／ｃＧＭＰ比值均显著低于正常对照组（Ｐ＜０．０５），而ｃＧＭＰ含量高于正常对照组（Ｐ＜０．０５）；ＭＳ和ＭＩ两组间ｃＡＭＰ、ｃＧＭＰ含量及ｃＡＭＰ／ｃＧＭＰ比值均无显著差异（Ｐ＞０．０５））；心肌β－ＥＰ和Ｌｅｕ－ＥＮＫ含量与ＬＶＥＦ、ＦＳ、ＬＣＷＩ、ＬＶＳＷＩ、ＣＩ、ＳＩ呈明显负相关（Ｐ＜０．０５）；心肌ＤｙｎＡ１－１３与ＬＣＷＩ、ＬＶＳＷＩ、ＣＩ、ＳＩ亦呈明显负相关（Ｐ＜０．０５）；心肌β－ＥＰ、Ｌｅｕ－ＥＮＫ和ＤｙｎＡ１－１３含量?
Objectives: To elucidate the correlationship of endogenous opioid peptides (EOP) with cardiac performance. Methods: The contents of βendophin (βEP), leuenkephalin (LeuENK) and dynorphin A113 (DynA113) in myocardium were determined by radioimmunoassay in 21 patients with rheumatic valvular heart disease (RHD) as well as 7 normal persons. Results: βEP, LeuENK and DynA113 contents in myocardium were significantly elevated in RHD patients as compared with those in normarl group (P<0.05) and the βEP and LeuENK were even much higher in mitral insufficiency group (MI) than in mitral stenosis group (MS) while the myocardial concentrations of cAMP and cAMP/cGMP ratio were decreased and cGMP increased significantly both in MI and MS as compared with those in normal group. βEP, LeuENK and DynA113 contents correlated negatively with cardiac index, strok index, left cardiac work index and left ventricular strok work index, respectively (P<0.05), and βEP and LueENK also correlated negatively with left ventricular ejection fraction as well as fractional shortening, respectively. Significant correlations of the contents of βEP, LeuENK or DynA113 with myocardial cAMP contents or cAMP/cGMP ratio but not with cGMP were documented. Conclusion: EOP might be synthesized in situ in human heart. The decreased myocardial contractility and the impaired pump function are closely related to the increased levels of EOP in the myocardium of RHD patients and cAMP may play a role in mediating the effect of the EOP.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
1997年第S1期34-38,共5页
Academic Journal of Second Military Medical University
关键词
内源性阿片肽
风湿性心脏病
心功能
endogenous opioid peptides
rheumatic heart disease, cardiac function
