IMD在冠状动脉造影及介入治疗前后的变化及临床意义

Changes of intermedin/adrenomedullin-2 after coronary angiography and intervention therapy and their clinical significance

目的观察IMD在冠状动脉造影及介入治疗前后的变化,以探讨IMD在冠心病疾病过程中的变化规律及临床意义。方法随机选取接受冠状动脉造影及介入治疗患者52例,分别于术前、术后24 h静脉取血获得血浆,采用放免法测定血浆IMD浓度,并与健康对照组(n=20)进行比较。结果冠造介入组患者治疗前IMD水平(pg/ml)明显低于健康对照组(146.85±33.10 vs 189.04±56.89,P<0.05),行冠状动脉造影及介入治疗后IMD水平显著升高(163.76±56.25,P<0.01)。治疗前冠状动脉造影不正常者IMD水平明显低于冠状动脉造影正常患者(135.50±29.34 vs 167.37±18.63,P<0.05),且术后均明显增高(P<0.05)。结论 IMD在冠心病患者中含量较低,其水平的降低可能为冠心病潜在危险因素之一。在行冠状动脉造影及介入治疗后,出现IMD水平的增高,可能与治疗过程中的出现心肌缺血再灌注损伤,机体出现代偿有关。

Objective To investigate the changes of intermedin-2/adrenomedullin-2（IMD/ADM-2） after coronary angiography and intervention therapy,and to explore the roles of IMD in the development of coronary heart disease and its clinical significance. Methods Fifty-two patients who received coronary angiography and intervention treatment were enrolled as treatment group.Plasma IMD contents were measured by radioimmunoassay in 52 patients before and after coronary angiography and intervention therapy for 24 h,and compared with 20 normal controls. Results ①IMD was significantly lower in patients than those in normal controls before treatment [（146.85±33.10）pg/ml vs（189.04±56.89）pg/ml,P0.05].②IMD significantly increased at 24 h after coronary angiography and intervention therapy in patients（P0.01）.③The content of IMD was lower in patients with normal coronary angiography than those in the abnormal ones before treatment[（135.50±29.34）pg/ml vs（167.37±18.63）pg/ml,P0.05],and both increased significantly after coronary angiography and intervention therapy（P0.05）. Conclusion IMD is lower in patients with coronary heart disease（CHD）,and the reduction of IMD could be a risk factor of CHD.The content of IMD get higher after coronary angiography and intervention therapy,which may be a compensatory reaction of myocardial ischemia and reperfusion injury.