冠心病患者血浆肾上腺髓质素浓度的变化  

Varieties of Plasma Adrenomedullin Concentration in Patients with Coronary Heart Disease

作　　者：王海滨[1] 赵东[2] 田青[2] 唐朝枢[2] 汤健[2] 张肇康[3] 石湘芸[4] 赵云涛[4] 聂智群[4] 丁殿勋[4] 

机构地区：[1]中日友好医院 [2]北京医科大学心血管基础研究所 [3]PhoemixPharmaceuticalsUSA [4]海军总医院心内科,北京100037

出　　处：《海军医高专学报》1996年第1期16-19,共4页

摘　　要：测定了48例冠心病(CHD)患者血浆肾上腺髓质素(Adm)的放免活性,结果示31例急性心肌梗塞(AMI)患者发病后即刻血浆Adm水平升高达峰值(118.4±9.49pg/ml),峰值较对照组(46.46±3.55pg/ml)增加1.5倍(p<0.001),第3天开始逐渐下降,第28天恢复至对照组水平,即刻血浆Adm与内皮素(ET)水平呈正相关(γ=0.9003,p<0.001);5例心绞痛(AP)发作时血浆Adm明显升高(101.7±10.15pg/m1),其值较对照组增加1.1倍p<0.001),AP缓释后2至3天恢复到正常水平;12例病情稳定的陈旧性心肌梗塞(OMI)患者血浆Adm轻度增高(70.55±10.99pg/ml);实验性心梗大鼠血浆Adm水平明显升高(p<0.001)。以上提示在血管壁及内皮细胞受损或(和)被激活后,多种血管活性肽的合成、释放及降解失衡,Adm释放增加,对维持机体循环的自身调节具有有益的保护作用。In our study ,immunoreactive of plasma adrenomedullin(Adm) concentration was measured in 48 patients with coronary heart disease (CHD). The results showed the mean plasm Adm concentration in 31 patients with acute myocardial infarction increased immediately to peak level (118.4 ±9.29pg/ml) after the acute attack , which whas 1. 5 times higher than the mean level(46.66±3.55pg/mL,P<0.001) in the control group. It reduced gradually in three days after heart attack and decresed to the control group's level till 28 days. The plasma Adm concentration was positively related to the concentration of endothelin (ET)(r = 0. 9003,P<0.001). The mean plasma Adm level in 5 patients with angina pectoris (AP)was 101.7±10.15pg/ml when angina pectoris broke out ,which was 1.1 times higher than the level in the normal group (P<0. 01). After 2 or 3 days when angina pectoris alleviated , it decreased to the normal level. The mean plasma level in 12 patients with stable remote myocardial infarction (MI) only increased slightly (70.55±10.99pg/ml). The mean plasma Adm level in experimental myocardial infarction rats increased significantly (P<0. 001). All these results suggested that more Adm release had a helpful protective effect on maintaining self-regulation of the body circulation when blood vessel walls and endothelio-cyte were injured or activated accompanied with the disturbance of release and decomposition of many vessel active peptides.

关 键 词：冠心病 冠状动脉疾病 肾上腺髓质素 病理 

分 类 号：R541.402[医药卫生—心血管疾病]