冠心病患者血浆内皮素和循环激素变化的临床观察

CLINICAL PBSERVATION ON THE CHANGES OF PLASMA EMDOTHELIN AND CIRCULATING HORMONES IN PATIENTS WITH CORONARY HEARH DIEASE

本文对９０例冠心病患者，３０例正常人应用放免法测定了血浆内皮素（ＥＴ）、肾素（ＰＲＡ）、血管紧张素ＩＩ（ＡＴＩＩ）、心钠素（ＡＮＦ）和皮质醇（Ｃｏｒｔｉｓｏｎ）的含量。结果显示在稳定、不稳定型心绞痛和心肌梗塞患者血浆ＥＴ、ＡＴＩＩ水平均较正常组显著增高（Ｐ分别＜０．０５和０．０１），不稳定型心绞痛和心肌梗塞组较稳定型心绞痛组增高更为明显（Ｐ分别＜０．０５），血浆ＡＮＦ水平在不稳定型心绞痛和心肌梗塞组中有明显增高（Ｐ＜０．０５）。本文结果表明ＥＴ和ＡＴＩＩ增高并与病情严重程度相一致，提示它们在心肌缺血和损伤的病理过程中起重要作用，ＡＮＦ水平增高可能具有负反馈调节效应，对其损害起拮抗作用。

he plasma endothelin(ET),renin activity(PRA),angiotensin II(AT II),atrial natri-uretic factor(ANF)and cortison were measured by a specific radioimmunoassay in 90 pa-tients with coronary heart disease and in 30 normal subjects,The results showed that theplasma levels of ET and AT II in the patients with stable or unstable angina pectoris and my-ocardial infarction were significantly higher than that in norn1al subjects(P<0.05 and P<0.01 respectively),and of these levels the in the patients with unstable angina pectoris andmyocardial infarction were signigicantly higher than that in the patients with stable anginapectoris(P<0.05).The plasma level of ANF in the patients with unstabe angina pectorisand myocardial infarction was significantly higher than that in normal subjects(P<0.05 ),It demonstrated that the increase of plasma ET and AT II was in accordance with severity ofthe disease and it might play an important role in the pathological process of myocardial is-chemia and impairment,while the increase of plasma ANF level might have a negative feed-back regulating effect and it could antagonise the impairment effect by the increase of plasmaET and AT II.