冠心病人运动前后外周血内皮素-1和一氧化氮的动态变化

Dynamic alterations of peripheral endothelin - 1 and nitric oxide concentrationsin coronary patients before and after exercisetesting

目的 探讨冠心病人运动耐量与内皮素－ １（ＥＴ－ １） 和一氧化氮（ＮＯ） 水平之间的关系。方法 ３２ 名冠心病人及２５ 名对照者平板试验前及停止后即刻，５ ｍｉｎ、６０ｍｉｎ 取外周血测ＥＴ－ １ 和ＮＯ并记录各运动参数。结果 运动后正常人ＮＯ 明显升高，升高幅度与最大氧耗呈正相关，ＥＴ－ １ 浓度不变；病人运动后ＮＯ 无明显变化，运动停止后６０ｍｉｎ ＥＴ－ １ 明显升高且升高幅度与血脂水平显著相关。结论 ＮＯ可能直接参与运动耐量的调节，冠心病人运动耐量降低可能与运动对ＮＯ分泌不足有关；ＥＴ对运动耐量无直接影响，冠心病人运动后ＥＴ增高程度受血脂水平影响。

Objective To study the relationship between exercise tolerance, endothelin - 1 (ET- 1) , and nitric oxide (NO) levels in patients with coronary artery disease (CAD) . Method Peripheral blood was withdrawn and exercise parameters recorded from CAD patients (n = 32) and controls (n = 25) before symptom - limited treadmill exercise testing (Bruce protocol) , duringthetesting,5 minutes after,and 60 minutes after the end of the testing .Results 1. Both the NOlevels and ET- 1 levels before the testing are comparable be tween the patients and the controls;2 . Afterthe begin ning of the exercise ,the NOlevels in the controls rose significantly andthe extentofincreaseiscloselyrelatedto the maximal oxygen consumption (VO2max) .60 minutes afterthe end ofthetesting,however,serum NOconcen tration dropped to aleveleven lowerthan thelevel before exercise.The ET- 1 concentrationinthecontrols,onthe other hand,remained constant duringthe experiment.3 . The patients did not develop NOconcentration alterations before and after exercise ,but ET- 1 level60 minutesaf terexercise did increase obviously ,and the extent ofin crease is strongly related to blood cholesterol concentra tion .Conclusions 1 .NOmight be directly involved in acute hemodynamic regulation during symptom - limited exercise testing; exercise intolerance of CAD patients might be partly attributed to insufficient secretion of NO during exercise.2 . ETmight have no immediate influ ence upon exercise-induced hemodynamicresponse .The extentof increase in ETlevel 60 minutes after exercise might be influenced by blood cholesterol level, but the mechanism is opento furtherinvestigation.