经皮腔内冠状动脉成形术对冠心病患者血和尿内皮素的影响  

Influence of Percutaneous Transluminal Coronary Angioplasty on Endothelin Levels in Patients with Coronary Heart Disease

作　　者：孙玲[1] 齐国先[1] 吴广成[1] 曾定尹[1] 胡大一[2] 贾三庆[2] 李田昌[2] 

机构地区：[1]中国医科大学附属第一医院循环内科 [2]首都医科大学附属红十字朝阳医院心脏中心

出　　处：《中国动脉硬化杂志》1997年第3期242-245,共4页Chinese Journal of Arteriosclerosis

摘　　要：为调查冠心病和内皮素之间存在的联系，并评价经皮腔内冠状动脉成形术过程中各种刺激因素对内皮素水平的影响，观察了15名采取经皮腔内冠状动脉成形术成功的患者股动脉血及尿液的内皮素水平，并与10名健康人作对照。结果发现冠心病患者血、尿基础内皮素值高于正常（P＜0．01）。经皮腔内冠状动脉成形术后股动脉血中内皮素水平无显著增加，尿中内皮素水平却增加3～6倍（P＜0．01），且持续24h以上。收缩期主动脉压力与尿中基础内皮素水平呈正相关（r=0．87，P＜0．01，n=15）。结果表明冠状动脉粥样硬化时内皮素水平高于正常。经皮腔内冠状动脉成形术过程中的血管损伤引起水后内皮素释放，尿内皮素值能较敏感地反映出经皮腔内冠状动脉成形术后内皮素的增加。Aim The synthesis and release of endothelin (ET)in patients with coronary heart disease undergary percutaneous transluminal coronary angioplasty has not been concluded. This study examined the porsible association between endothelin and coronary atherosclerosis and evaluated the synthesis and release of endothelin in the presence of various stimuli that occur during percutaneous transluminal coronary angioplasty.Methods The plasma from femoral artery blood and urinary concentrations of endothelin immunoreactivity in 15 patients and 10 healthy control subjects were measured before and after percutaneous transluminal coronary angioplasty.Results The basic plasma and urinary ET-1 level was higher than the control subjects (<0.01).Changes were not detected in peripheral plasma concentrations of ET-1 within 24 h (P<0. 05), but found increase in urinang ET-l levels from 50±12 to 274±54pg/kg of creative a few hours after coronary angioplasty (P<0.01). The increase excretion persisted for more than 24 hours. It was found that systolic aortic pressure was correlated with basal uninary excretion of ET-l within the range of nomal (r=0 87, P<0.01, n=15), but balloon size, dilating times and duration were not associated with ET-l level.Conclusion ET-l concentration of patients with coronary heart disease was higher than the control subjects. Vascular injury during coronary angioplasty increase urinary ET-l levels a few hours after the procedure. This increase was not detectable by sampling of femoral artery blood. Systolic aortic pressure was related to urinary ET-l. Larger clinical studies are required to further elucidate the biologic importance of endothelin in patients with coronary heart disease.

关 键 词：冠心病 冠状动脉成形术 PTCA 内皮素 

分 类 号：R654.105[医药卫生—外科学]