休克患者血浆肾上腺髓质素与血管阻力变化的关系

The relationship between plasma adrenomedullin levels and vascular resistance in patients with shock

目的：观察休克患者血浆肾上腺髓质素（ＡＤＭ）与血管阻力变化，探讨其在休克病理生理过程中的作用。方法：应用放射免疫方法检测４６ 例休克患者血浆ＡＤＭ 浓度，无创胸导生物电阻抗方法测定平均动脉压（ＭＢＰ）、全身血管阻力（ＳＶＲＩ）和心排指数（ＣＩ）。结果：休克组治疗前血浆ＡＤＭ 浓度明显高于正常对照组（Ｐ＜０．０１）；感染性休克组高于非感染性休克组（Ｐ＜ ０．０５）；死亡组高于存活组（Ｐ＜ ０．０５）；感染性休克组ＳＶＲＩ较其他组明显降低，而ＣＩ较正常组略高，其他休克组则明显降低（Ｐ＜ ０．０５）。结论：ＡＤＭ 与血管阻力变化相关，并参与了休克的病理生理过程。

Objective:To investigate the relationship between plasma adrenomedullin (ADM) levels and systemic vascular resistance index (SVRI),and their role in the pathogenesis of shock.Methods:Plasma ADM levels were measured in 46 patients with shock by specific radioimmunoassay.And measurements of mean blood pressure,SVRI,cardiac index (CI) were noninvasively performed by electrical bioimpendance.Results:Plasma ADM levels were significantly higher in shock group than healthy controls ( P <0 01),also,ADM levels increased markedly in group with septic shock than that in group without septic shock ( P <0 05).SVRI decreased and CI slightly increased in septic shock compared with other groups ( P <0 05).Conclusions:The results indicate that ADM appears to be associated with SVRI,which might plays an important role in the pathogenesis of shock.