血浆降钙素基因相关肽与冠心病患者冠状动脉病变严重程度及左心室功能的关系

为探讨血浆降钙素基因相关肽浓度与冠心病患者冠状动脉病变严重程度及左心室功能的关系 ,应用放射免疫法检测 42例选择性冠状动脉造影主要分支狭窄≥ 70 %的患者和 15例正常人的血浆降钙素基因相关肽浓度 ,并作Leaman冠状动脉记分 ,左心室造影测左心室射血分数 ,研究血浆降钙素基因相关肽浓度与Leaman冠状动脉记分及左心室射血分数之间的关系。结果发现 ,冠心病患者血浆降钙素基因相关肽浓度明显低于正常对照者(2 76 .12± 16 4.75ng/L比 411.44± 110 .32ng/L ,P <0 .0 1) ;血浆降钙素基因相关肽浓度与Leaman记分呈显著负相关 (r=- 0 .6 1,P <0 .0 0 1) ,而与左心室射血分数呈显著正相关 (r=0 .5 7,P <0 .0 0 1) ;患者全组Leaman记分与左心室射血分数无明显相关 ,但在血浆降钙素基因相关肽浓度 <2 5 0ng/L的亚组 ,Leaman记分与左心室射血分数呈显著负相关 (r=- 0 .49,P <0 .0 5 )。结果提示 ,血浆降钙素基因相关肽水平与冠心病患者的冠状动脉病变严重程度和左心室功能均有一定关系 ;血浆降钙素基因相关肽水平降低的冠心病患者左心室功能随冠状动脉病变的加重而减退。血浆降钙素基因相关肽浓度变化可能在冠状动脉粥样硬化的发生发展及冠心病患者左心室功能降低的发病机制中有一定意义。

The Relationships between Plasma Clcitonin Gene Related Peptide and the Severity of Coronary Lesions as well as Left Ventricular Function in Patients with Coronary Heart Disease

Aim To investigate the relationships between plasma calcitoningenerelated peptide (CGRP) and the severity of coronary lesions and left ventricular function in patients with coronary heart disease. Methods In 42 patients with fixed stenosis coronary artery ≥70% of luminal diameter in the major coronary arteries and 15 normal persons, the concentration of plasma CGRP was measured using radioimmunoassay (RIA). The relationships between plasma CGRP and the Leaman coronary artery score as well as left ventricular ejection fraction (LVEF) were assessed. Results The concentration of plasma CGRP was obviously lower in the coronary disease group than in the control group (276.12±164.75 ng/L vs 411.44±110.32 ng/L, P<0.01). The concentration of plasma CGRP was negatively related to the Leaman score (r=－0.61, P<0.001) and positively to LVEF (r=0.57, P<0.001). The Leaman score had no significant correlation to LVEF in the whole group. However, in the subgroup with the level of plasma CGRP <250 ng/L, the Leaman score had significantly negative correlation to LVEF (r=－0.49, P<0.05). Conclusions The plasma CGRP had correlation to both the severity of coronary lesions and left ventricular function in patients with coronary heart disease. In the patients with decreased concentration of plasma CGRP, the left ventricular function deteriorated with the progress of coronary lesions.