冠心病患者血浆IMD/ADM-2含量及介入治疗后的变化

Changes of Plasma IMD/ADM-2 Contents After Intervention Therapy in Patients with Coronary Heart Disease

目的:研究冠心病患者血浆Intermedin/adrenomedullin 2(IMD/ADM-2)水平的变化以及介入治疗对其的影响,以初步探讨其在该疾病过程中可能扮演的角色。方法:对拟行经皮冠状动脉腔内成形术(PTCA)及支架置入术(CS)的冠心病患者30例,分别于术前、术后24h及72h静脉采血,放免法测定血浆ADM、IMD/ADM-2浓度,并同健康对照组(n=36)进行比较。结果:①冠心病组血浆IMD/ADM-2水平较对照组低36.5%(P<0.01),ADM水平则较对照组高64.6%(P<0.01)。②随着受累冠脉支数的增多,血浆IMD/ADM-2水平呈渐增趋势,而ADM的变化与之相反,但差异无统计学意义(P均>0.05)。③PTCA+CS术后24h,血浆ADM、IMD/ADM-2浓度较术前差异无显著性(P均>0.05);术后72h,血浆IMD/ADM-2较术前及术后24h分别升高了25.2%和29.2%(P均<0.05);而ADM则较术前及术后24h降低了30.6%和22.6%,(P均<0.05)。④冠心病组血浆ADM与IMD/ADM-2含量间无显著性相关(r=-0.358,P=0.174)。结论:IMD/ADM-2可能与冠心病的发生、发展及转归有关,其作用机理及病理生理学意义可能有别于ADM。

Objective To study the possible role played by intermedin （IMD） adrenomedullin - 2 （ ADM - 2） in the developmont of coronary heart disease （CHD） through measurement of the changes of its plasma conteut after intervention therapy. Methods Plasma IMD/ADM -2 and adrenomedullin （ADM） contents were measured with RIA in 36 contrels （only once） and repeatedly in 30 padents with CHD before, 24h, and 72h after pereutaneous transluminal coronary angioplasty （PTCA） with placement of stent. Resuits （1） Before intervention therapy, the plasma eoutents of IMD/ADM - 2 in the patients were significantly lower while the plasma ADM contents were significantly higher than those in eontrels （ both P 〈0.01 ）. （2） The plasma coutents of IMD/ADM -2 were higher in the patients with more vessels blocked and the ADM coutents were lower, but both changes were not significantly. （3） The plasma contents of IDM/ADM -2 and ADM changes somewhat but not significantly 24h after PTCA. However, at 72h, the plasma IMD/ADM - 2 contents were significantly increased （ P 〈 0.05 ）, but plasma ADM contents were significantly decreased （ P 〈 0.05 ）. （4） No eorrelationship existed between the plasma contents of ADM and IMD/AMD -2 （r = -0. 358, P = 0. 174）. Conclusion IMD/AMD - 2 might play some role in the development of CHD, but the exact mechanism was not fully understood.