冠心病患者血浆降钙素基因相关肽水平同早期心功能障碍的关系

Relationship between plasma calcitonin gene-related peptide level and early cardiac dysfunction in patients with coronary artery disease

目的 明确降钙素基因相关肽能否作为冠心病早期心功能障碍的预测指标。方法 随机入选经冠状动脉造影确诊正常及冠心病病例共６０ 例，依据病变累及冠状动脉的支数分为四个亚组（０ 支、１ 支、２ 支、３ 支病变组） 各１５ 例；左心导管及左室电影造影测定血流动力学参数；放免法测定血浆降钙素基因相关肽浓度。结果 左室射血分数随着冠状动脉病变程度加重逐渐降低，但亚组间差异不显著（ 仅Ｐ３∶０ ＜ ００５） ；舒张功能参数亚组间差异显著，以时间常数为明显（ Ｐ＜ ００１） ，它同冠状动脉狭窄积分呈正相关（ｒ ＝ ０７２ ，Ｐ＜ ００１） 。降钙素基因相关肽同冠状动脉狭窄积分、时间常数呈正相关（ｒ＝ ０３７ ～０５０ ，Ｐ＜ ００５ 或Ｐ＜ ００１） ；同左室射血分数呈负相关（ｒ＝ － ０４６ ，Ｐ＜ ００１） 。结论 降钙素基因相关肽在冠心病患者早期舒张功能障碍预测上具有一定的价值。

Objective To identify whether plasma calcitonin gene-related peptide(CGRP)level is index for evaluatin early cardiac dysfunction in patients with coronary artery disease.Methods Normal and coronary artery disease total sixty cases were chosen at random,which were diagnosed by coronary arteriography,four subgroups(0、1、2、3 lesion branch group)were divided basing on coronary artery lesion branch,each having fifteen cases.Hemodynamic parameters were measured by left cardiac cather and left ventricular cineangiography.Plasma CGRP concentration was measured by radionimmunoassay.Results LVEF decressed as coronary artery lesion branch increased,but there were no significantly difference between subgroups(only P 3∶0 <0 05),there were significantly difference of diastolic function parameters between subgroups,especially T,had positive relativity to stenosis score( r =0 72, P <0 01).Plasma CGRP level had positive relativity to stenosis score、time constant( r =0 37～0 38, P< 0 05);had negative realativity to LVEF( r =-0 46, P <0 01).Conclusions Coronary artery disease imparies diastolic function prior to systolic function;CGRP is a important index for evaluating early cardiac dysfunction in patients with coronany artery disease. [