充血性心力衰竭患者血浆肾上腺髓质素含量变化及其意义

The Changes of Plasma Adrenomedullin Levels in Patients withCongestive Heart Failure and Their Significance

用放射免疫法检测８０例充血性心力衰竭（ＣＨＦ）患者血浆肾上腺髓质素（ＡＭ）含量，同时分析了血浆ＡＭ与左室射血分数（ＬＶＥＦ）和心胸比率的相关性，以观察不同程度ＣＨＦ患者血浆ＡＭ含量变化，并探讨其临床意义。结果发现：①ＣＨＦ患者血浆ＡＭ含量（５０．６４±２３．１２）ｎｇ／Ｌ，明显高于正常人（１６．８２±４．４８）ｎｇ／Ｌ，Ｐ＜０．００１；②血浆ＡＭ水平与心力衰竭严重程度相平行，心衰程度越严重，ＡＭ水平越高；③血浆ＡＭ与ＬＶＥＦ呈显著负相关（ｒ＝－０．６２５８，Ｐ＜０．００１），与心胸比率呈显著正相关（ｒ＝０．６０３７，Ｐ＜０．００１）。提示，ＡＭ参与了ＣＨＦ的病理生理过程。

Plasma adrenomedullin (AM) was measured by radioimmunoassay in 80 patients with congestive heart failure (CHF) and 30 healthy control subjects and the corelativity of the plasma AM levels with left ventricular ejection fraction (LVEF) and cardiothoracic ratio was analysed. The results showed that: ①The plasma level of AM in patients with CHF was significantly higher than that in control subjects (5064±2312) vs (1682±448) ng/L, P<0001; ②The elevated plasma AM of patients in CHF parallel to the severity of CHF, the severer the CHF, the higher the AM; ③There was a significantly negative correlation between the plasma AM levels and LVEF in patients with CHF (r=-06258, P<0001) and a significantly positive correlation between the plasma AM levels and the cardiothoracic ratio (r=06037, P<0001). These results suggest that AM might play a certain role in the pathophysiology of CHF and the plasma AM levels in patients with CHF may serve as an index of the severity of CHF.