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目的 :以外周血淋巴细胞作为心肌组织的窗口 ,通过测定急性心肌梗死 (AMI)患者淋巴细胞内的血管紧张素Ⅱ (AngⅡ ) ,初步探讨AMI时心肌局部组织肾素 血管紧张素系统 (RAS)的意义 ,并与血浆内的AngⅡ进行对比研究。方法 :选择 30例AMI患者为病例组 ,于入院即刻采外周静脉血收集血浆并分离淋巴细胞 ;另选2 0例健康人为对照组。分别测定AMI及对照组人群的血浆及淋巴细胞内AngⅡ。将所得数据进行回顾性分析。结果 :①AMI患者及健康人外周血淋巴细胞内AngⅡ浓度与血浆含量均无相关性 ;②AMI发病 6h以内及 6～ 2 4h ,血浆及淋巴细胞中AngⅡ均较对照组明显升高 ;③AMI发病 2 4h以后病例 ,血浆中AngⅡ含量已开始下降 ,而淋巴细胞中AngⅡ未见下降 ;④淋巴细胞中AngⅡ浓度与AMI后左室质量 (LVMASS)呈正相关 ,而血浆内AngⅡ与LVMASS无相关性。结论 :AMI后心肌组织RAS和循环RAS均被激活 ,心肌组织RAS的激活较循环RAS持久 ;在AMI后心室重塑中 ,心肌组织RAS的激活更有意义
OBJECTIVE: To investigate the effects of peripheral blood lymphocytes (AMI) on angiotensin Ⅱ (AngⅡ) in lymphocytes of patients with acute myocardial infarction (AMI) by using peripheral blood lymphocytes as a window of myocardium, and to explore the role of renin-angiotensin system (RAS) Significance, and with plasma Ang Ang comparative study. Methods: Thirty patients with AMI were selected as case group. Peripheral venous blood was collected immediately after admission and lymphocytes were separated. Twenty healthy controls were selected as control group. The levels of Ang Ⅱ in plasma and lymphocytes of AMI and control groups were measured respectively. The data obtained for retrospective analysis. Results ① There was no correlation between AngⅡ concentration and plasma levels in peripheral blood lymphocytes of patients with AMI and healthy people; ② Angi levels in plasma and lymphocytes were significantly increased within 6h and 6-24h after AMI onset; In later cases, the content of AngⅡ in plasma began to decline, but there was no decrease in AngⅡ in lymphocytes. ④The concentration of AngⅡ in lymphocytes was positively correlated with LVMASS, while there was no correlation between AngⅡ and LVMASS in plasma. CONCLUSION: RAS and circulatory RAS are all activated in myocardium after AMI, and the activation of RAS in myocardium is longer than that of RAS. In the ventricular remodeling after AMI, the activation of RAS is more meaningful