冠心病患者血浆肾上腺髓质素前体N端20肽的变化

目的：观察冠心病患者血浆肾上腺髓质素前体N端20肽（PAMP）水平的变化并探讨其临床意义。方法：经冠状动脉造影确诊的冠心病病人66例被分为三组：稳定型心绞痛组（SAP）21例，不稳定型心绞痛组（UAP）29例，急性心肌梗塞组（AMI）16例，对照组为经冠脉造影证实无冠心病的患者23例，所有研究对象取空腹卧位周围静脉血5ml，用放射免疫分析法测定血浆中PAMP浓度。结果：对照组、SAP组、UAP组与AMI组PAMP血浆含量依次为（5．55±0．97）ng／L、（9．25±2．95）ng／L、（13．07士1．29）ng／L、（15．52±4．60）ng／L，冠心病三组PAMP血浆含量明显高于对照组（P均〈0．01），在冠心病组中，UAP组与AMI组PAMP血浆含量明显高于SAP组（P均〈0．01）。结论：冠心病患者血浆PAMP水平升高，而UAP组与AMI组升高更明显，提示PAMP参与了冠心病的病理生理过程。

Changes of plasma proadrenomedullin N terminal 20 peptide in patients with coronary artery disease

Objective： To study the changes of plasma proadrenomedullin N terminal 20 peptide （PAMP） in patients with coronary artery disease （CAD） and its clinical significance. Methods： The 66 CAD patients were confirmed by selective coronary angiography. In this selected series of CAD patients, 21 patients were suffering from stable angina （SAP）, 29 patients unstable angina （UAP） and 16patients acute myocardial infarction （AMI）. In another 23 patients who had received coronary angiography and no obvious pathology lesion had been found were studied as control. Venous blood samples at rest were collected and the plasma PAMP levels were measured by radioimmunoassay. Results.. The plasma levels of PAMP was （5.55±0.97） ng/L in control group, and （9.25±2.95） ng/L, （13.07±1.29） ng/ L, （15.52±4.60） ng/L in SAP group, UAP group and AMI group respectively, which were significantly higher in CAD groups than that in control group （P〈0.01）. The concentration of PAMP in UAP group and AMI group were higher than that in SAP group （P〈0.01）. Conclusion： The PAMP levels of plasma in CHD patients are elevated and significantly increased in UAP group and AMI group, which may involved in the pathophysiological process of CHD.