充血性心力衰竭患者血浆肾上腺髓质素水平观察

Plasma adrenomedullin level in patients with congestive heart failure

为研究充血性心力衰竭（ＣＨＦ）患者在不同心功能状态下及治疗前后血浆肾上腺髓质素（ＡＭ）含量，同时分析血浆ＡＭ含量与内皮素（ＥＴ）和血管紧张素Ⅱ（ＡｎｇⅡ）含量之间的关系。用放射免疫法测定了５１例ＣＨＦ患者和３０例健康对照组的血浆ＡＭ、ＥＴ和ＡｎｇⅡ含量。结果显示：①ＣＨＦ组不同程度心功能患者血浆ＡＭ、ＥＴ、ＡｎｇⅡ含量均较对照组明显增高（Ｐ＜０００１），且血浆ＡＭ、ＥＴ、ＡｎｇⅡ含量随心功能级别增高而升高。②心功能改善后，血浆ＡＭ、ＥＴ及ＡｎｇⅡ含量较治疗前显著下降（Ｐ＜０００１），但仍高于对照组（Ｐ＜００１）。③ＣＨＦ患者治疗前后血浆ＡＭ与ＥＴ、ＡｎｇⅡ含量均呈显著正相关。结果提示：血浆ＡＭ升高可能与ＥＴ和ＡｎｇⅡ含量升高有关，血浆ＡＭ含量不仅可反映心力衰竭严重程度。

To observe the changes of plasma adrenomedullin(AM) levels in patients with congestive heart faiure(CHF) under different conditions of cardiac function before and after treatment and study the correlationplasma AM with endothelin(ET) and angiotensin Ⅱ (Ang Ⅱ),plasma AM,ET,and Ang Ⅱ concentration were determined by radioimmunoassay in 51 patients with CHF and 30 healthy subjects.Results revealed that the plasma AM concentration were significantly higher( P <0.001) in patients with CHF than that in control subjects.The increases of plasma AM、ET and Ang Ⅱ were corresponding to the severity of CHF.The plasma levels of AM、ET and Ang Ⅱ in 51 patients with CHF decreased significantly( P < 0.001) after treatment as compared with those before treatment,but they were still higher than those in the control subjects ( P <0.01).There was a significant positive correlation between the plasma levels of AM,and ET and Ang Ⅱ before and after treatment.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.The plasma AM levels in patients with CHF may serve as an index of the severity of CHF and the judgement of curative effect in CHF.