冠心病患者内皮细胞的损伤及其机制

STUDIES ON MECHANISM OF ENDOTHELIUM DYSFUNCTION IN CORONARY HEART DISEASE

目的了解冠心病（ＣＡＤ）患者动脉内皮细胞的损伤情况，探讨内皮细胞功能障碍与冠心病的机制。方法采用二维超声检测ＣＡＤ患者肱动脉血管内径（内皮依赖性和内皮非依赖性舒缩功能），同时采用放射免疫法测其血浆平均一氧化氮（ＮＯ）、内皮素（ＥＴ）、ＥＴ／ＮＯ比值、肾素活性（ＰＲＡ）、心钠素（ＡＮＰ）浓度，并以３２例健康人为对照。结果ＣＡＤ组内皮依赖性血管舒缩功能与对照组相比明显降低，内皮非依赖性血管舒缩功能与对照组无显著差异；与对照组相比，ＣＡＤ组血浆平均ＥＴ、ＰＲＡ、ＥＴ／ＮＯ显著升高，而血浆ＮＯ、ＡＮＰ水平显著降低。结论内皮功能障碍及其内源性血管活性物质的失衡在ＣＡＤ的发病机制中起重要作用。

Objective To investigate the mechanism of endothelium dysfunction and the mechanism of endothelium dysfunction in patients with coronary artery disease (CAD).Method Two-dimensional echocardiography (2-DE) was used to measure fore brachial artery inner diameter with 42 CAD patients (endothelium dependant and endothelium nondependant systolic function), plasma level of endothelium (ET), nitric oxide (NO), atrial natriuretic peptide (ANP) and plasma renin activity (PRA) were measured with radioimmunossay and chemistry method. And 32 healthy person were included in control group.Results Endothelium dependant vascular diastolic-systolic function was significantly decreased in CAD group as compared with control groups;while endothelium non-dependant diastolic-systolic function was not significant in CAD group compared with control group. The plasma level of ET, PRA, ET/NO was higher and that of NO, ANP was significantly lower in CAD group than in control group.Conclusion Edothium dysfunction and the unbalance of endogenous vaso-active substances may play an important role in the pathology of CAD.