慢性心力衰竭患者血浆肾上腺髓质素和cAMP含量的变化及相互关系

Changes in plasma levels of adrenomedullin and cyclic adenosine monophosphate and their interrelation in patients with chronic heart failure

目的测定慢性心力衰竭（CHF）患者血浆肾上腺髓质素（ADM）和环磷酸腺苷（cAMP）含量的变化,探讨其在心力衰竭发生发展过程中的作用机制。方法 用放射免疫方法测定45例CHF患者和20例健康查体者血浆ADM、cAMP含量,CHF组按美国纽约心脏协会（NYHA）标准进一步分为Ⅱ级、Ⅲ级、Ⅳ级3个组进行比较分析。结果 NYHAⅡ、Ⅲ、Ⅳ级组血浆 ADM、cAMP含量明显高于对照组（P<0.05）,在Ⅲ级组达到高峰,Ⅳ级组反而下降;ADM与cAMP存在正相关关系（r=0.735,P<0.01）。结论血浆ADM、cAMP的水平与心功能不全密切相关,在病程不同阶段呈动态变化;ADM与。cAMP之间存在着正相关关系,说明ADM与cAMP存在相互调节作用,cAMP含量的升高部分来源于ADM升高的刺激。

Objective To investigate the changes in plasma levels of adrenomedullin (ADM) and cyclic adenosine monophos-phate (cAMP) in patients with chronic heart failure (CHF) in an attempt to understand the role of ADM in the occurrence and development of CHF. Methods The plasma levels of cAMP and ADM were measured by radioimmunoassay in 45 patients with CHF (including 10 of NYHA class II, 15 of class III, and 20 of class IV) and 20 healthy controls respectively. Results Plasma ADM and cAMP levels significantly increased in patients of NYHA class II, III, and IV as compared with the healthy controls (P<0.05), with those of class M patients being the highest. Positive correlation between ADM and cAMP was noted in CHF patients (r=0.735, P<0.01). Conclusion Plasma levels of ADM and cAMP were in close correlation with the degree of heart failure, varying dynamically with the development of heart failure. There was mutual accommodation between ADM and cAMP, and increased cAMP level partly results from elevated ADM level in CHF patients.