不对称二甲基精氨酸在肺动脉高压中的作用与临床意义

Asymmetric dimethylarginine in pulmonary hypertension

不对称二甲基精氨酸(asymmetric dimethylarginine,ADMA)是一种内源性一氧化氮合酶抑制剂。近年来的研究认为它是心血管疾病的独立危险因子。ADMA的水平增高可能参与一些心血管疾病如原发和继发性肺动脉高压的发生、发展,并与疾病的严重程度和预后密切相关。本文从ADMA的代谢及其相关因子的关系着手。从另一层面对肺动脉高压的发生发展作一综述,并为治疗提供新的线索和途径。

Asymmetric dimethylarginine （ADMA） is an endogenous inhibitor of nitric oxide synthase. Studies have indicated that ADMA is closely correlated with endothelial dysfunction and many cardiovascular diseases such as end - stage renal disease, hypertension, diabetes and hypercholesterolemia. ADMA affects vascular reactivity, regulates vascular resistance,vascular smooth muscle cell proliferation, leukocyte adhesion, and platelet aggregation. The production of ADMA is balanced by its metabolism by dimethyl- arginine dimethylaminohydrolase （DDAH）. Increased plasma levels of ADMA may contribute to vascular abnormalities in pulmonary arterial hypertension and other cardiovascular diseases.