冠心病患者冠状动脉循环中肾上腺髓质前体N端20肽的变化

Levels of proadrenomedullin N terminal 20 peptide in patients with coronary disease and the changes after coronary circulation

目的:研究冠心病(CHD)患者肾上腺髓质素前体N端20肽(PAMP)浓度在冠状动脉循环过程中的变化。方法:用放射免疫方法分别测定冠心病患者(冠心病组)与对照组外周、冠状静脉窦与主动脉根部血浆中PAMP浓度。结果:冠心病组外周、冠状静脉窦与主动脉根部血浆中PAMP浓度均明显增高,与对照组比较均差异有统计学意义(P<0.01),冠心病组冠状静脉窦PAMP水平与主动脉根部及外周血浆中PAMP浓度比较均有统计学意义(P<0.01)。结论:PAMP参与了冠心病的病理生理过程,可能是机体对维持内环境稳态的一种自我保护机制,在冠心病的病程发展过程中有可能是一种较为重要的血管活性物质。

Objective：To investigate the levels of proadrenomedullin N terminal 20 peptide（PAMP）in patients with coronary heart disease （CHD）and the changes after coronary circulation in patients with CHD. Method.. The 64 patients with coronary heart disease were studied. Blood samples were collected during percutaneous coronary intervention （PCI） from peripheral circulation, aortic root （Ao） and coronary sinus （CS）, and the concentrations of PAMP were measured respectively. The sino-arterial （CS-Ao） difference was measured as cardiac PAMP. Result.. The concentration of PAMP in patients with CHD increase significantly in peripheral circulation and coronary sinus, and the concentration of PAMP in coronary sinus were higher than peripheral circulation and aorta （P d0. 01）, The CS-Ao differences of PAMP in CHD were much higher than control groups （P〈0.01）. The significant positive correlation among peripheral circulation, coronary sinus, Conclusion.. PAMP may be involved in the process of pathophysiology in patients with coronary disease and may be one of the protective mechanisms to the stabilization of organism internal environment. These results indicate PAMP may be one of the important vasoactive substances in the process of CHD.