充血性心力衰竭患者肾上腺髓质素与内皮素、血管紧张素Ⅱ结果比较

A comparision between adrenomedullin, endothelin and angiotensin Ⅱ in patients with congestive heart failure

目的研究充血性心力衰竭（CHF）患者血浆肾上腺髓质素（AM）含量变化及其与血浆内皮素（ET）、血管紧张素Ⅱ（AngⅡ）的关系。方法用放射免疫法测定95例CHF患者（CHF组）和50例正常人（正常对照组）的血浆AM、ET和AngⅡ含量,同时用彩色超声心动图测定56例CHF患者的左心室射血分数（LVEF）。结果CHF患者血浆AM高于正常对照组;CHF患者血浆AM、ET、AngⅡ升高程度与心力衰竭严重程度正相关;CHF患者血浆AM与ET、AM与AngⅡ均呈显著正相关;血浆AM与LVEF呈显著负相关（r=-0.6258,P〈0.001）,与心脏横径/胸廓最大内径呈显著正相关（r=0.6037,P〈0.001）。结论AM参与了CHF的病理生理过程,血浆AM升高可能与血浆ET和AngⅡ升高有关。

Objective To observe the changes of plasma adrenomedu （AM）, endothelin （ET） and angioteusin Ⅱ （ Ang Ⅱ） in patients with congestive heart failure（CHF）. Methods Plasma AM, ET and Ang Ⅱ levels were determined by radioimmuncassay in 95 patients with CHF and 50 healthy control subjects. In 95 patients with CHF, the left ventricular ejection fraction （LVEF） of 56 patients was measured by echocardiography. Results The plasma AM levels were significantly higher in patients with CHF than that in control subjects. The increase of plasma AM, ET and Ang II was parallel with the severity of CHF. There was a significant correlation between plasma levels of AM and ET （ r=0.7218, P〈0.01） and Ang Ⅱ （ r=-0.6566, P〈0.001）. LVEF inversely correlated（r=-0.6258 , P〈0.001） with plasma AM levels and significantly positive correlated between the plains AM levels and the cardiothoracic ration（r=-0.6037, P〈0.05） in patients with CHF. Conclusions These results suggest that AM might play a certain role in the pathophysiology of CHF. The elevated plasma ET and Ang Ⅱ may be responsible for the rise of plasma AM levels in patients with CHF.