心力衰竭患者血浆肾上腺髓质素和升压素的变化  

CHANGES OF PLASMA ADRENOMEDULLIN AND ADRENOTENSIN CONCENTRATIONS IN PATIENTS WITH CONGESTIVE HEART FAILURE

作　　者：高玉琪[1] 李志樑[2] 吴宏超[2] 陆青[2] 唐朝枢[3] 

机构地区：[1]济南军区总医院,济南250031 [2]第一军医大学珠江医院 [3]北京大学第一医院心血管所

出　　处：《解放军医学杂志》2003年第3期238-240,共3页Medical Journal of Chinese People's Liberation Army

基　　金：国家重点基础研究发展规划项目基金资助课题 (编号G2 0 0 0 0 5690 5)

摘　　要：为探讨肾上腺髓质素(ADM)和肾上腺升压素 (ADT)在充血性心力衰竭 (CHF)发展中的变化及其临床意义 ,采用特异性放射免疫法检测 45例CHF患者治疗前后ADM和ADT血浆浓度。结果显示 ,治疗前心功能Ⅱ、Ⅲ级组患者ADM血浆浓度分别为 5 1 46±4 5 2pg/ml、70 3 9± 3 2 2 pg/ml,ADT为 2 9 98± 1 13 pg/ml、3 3 45± 0 91pg/ml,与对照组的ADM ( 2 4 12± 1 5 9pg/ml)、ADT( 2 4 89±2 19pg/ml)比较差异有显著性意义(P <0 0 5 ) ;心功能Ⅳ级组ADM和ADT浓度分别为 3 6 3 3± 2 17pg/ml和 2 0 71±0 75 pg/ml,明显低于Ⅱ、Ⅲ级组和对照组(P <0 0 5 )。治疗后 ,Ⅱ、Ⅲ级组ADM和Ⅲ级组ADT浓度较治疗前明显降低 (P <0 0 5 ) ,余各组ADM和ADT浓度与治疗前比较差异无显著性意义。提示ADM和ADT在CHF不同阶段发生调节紊乱 ,共同参与了心衰的发展过程 。To investigate the changes of plasma adrenomedullin(ADM) and adrenotensin(ADT) levels and their clinical significance in the pathological process of congestive heart failure(CHF), plasma levels of ADM and ADT in 45 patients with CHF before and after treatment were measured by specific radioimmunoassay. The results indicated that before treatment, plasma levels of ADM in class Ⅱ and Ⅲ CHF patients were 51.46±4.52pg/ml, 70.39±3.22pg/ml and plasma levels of ADT in class Ⅱ and Ⅲ CHF patients were 29.98±1.13pg/ml, 33.45±0.91pg/ml, respectively,which were higher than those of the control subjects(24.12±1.59pg/ml and 24.89±2.19pg/ml, respectively)(P<0.05). Plasma levels of ADM and ADT in class Ⅳ patients were 36.33±2.17pg/ml and 20.71±0.75pg/ml, respectively, which were lower than those of class Ⅱ and Ⅲ patients and the control subjects(P<0.05). After treatment, plasma levels of ADM in class Ⅱ and Ⅲ patients and ADT in class Ⅲ patients were much lower than those before treatment (P<0.05). There was no significant differences in plasma levels of ADM and ADT in patients with other CHF classes compared with those before treatment. The changes of plasma concentrations of ADM and ADT in patients with CHF in different stages showed a regulative disorder of vasoactive peptides among the intramolecule of proadrenomedullin. It is suggested that ADM and ADT might be combinatively involved in the development of CHF and may serve as an assessment index.

关 键 词：心力衰竭 充血性 肾上腺髓质素 肾上腺升压素 放射免疫测定 

分 类 号：R541.61[医药卫生—心血管疾病]