冠状动脉病变主动脉局部血浆血管紧张素Ⅱ纤溶酶原激活物抑制剂-1水平观察

目的观察冠心病患者主动脉局部血浆血管紧张素Ⅱ(AngⅡ)、纤溶酶原激活物抑制剂-1(PAI-1)水平及二者的相关性,探讨二者在冠状动脉病变发生中的可能机制。方法所有入选患者均行冠状动脉造影,根据冠状动脉造影结果将患者分为冠状动脉狭窄病变组患者42例(冠心病组)和冠状动脉正常组21例(对照组)。造影同时于主动脉根部采集血标本,用放射免疫法测定血浆AngⅡ水平,酶联免疫吸附试验(ELISA)测定血浆PAI-1水平。结果①冠心病组与对照组相比,主动脉血浆AngⅡ水平为(46±11)pg/mlvs(37±5)pg/ml(P<0.05);PAI-1水平为(26±8)ng/mlvs(19±6)ng/ml(P<0.05)。②冠心病组AngⅡ与PAI-1二者间呈显著性正相关(r=0.46,P<0.05)。③3支病变组AngⅡ水平和PAI-1水平均显著高于单支病变组(52±7)pg/mlvs(38±11)pg/ml,P<0.05,AngⅡ];(35±15)ng/mlvs(21±7)ng/ml,P<0.01,PAI-1]。结论冠心病组主动脉局部血浆AngⅡ、PAI-1水平明显升高,AngⅡ与PAI-1水平呈显著性正相关,提示肾素血管紧张素系统与纤溶系统功能紊乱相关,可能共同促进冠状动脉狭窄的发生发展。

An observational study on aortic plasma levels of angiotensin Ⅱ and plasminogen activator inhibitor-1 in patients with coronary artery stenosis

Objective To determine the aortic plasma levels and correlation of angiotensin Ⅱ(AngⅡ)with plasminogen activator inhibitor(PAI)-1 in coronary artery stenosis for their potential roles in pathogenesis.Methods The participants were divided into the coronary stenosis group(CHD group,n=42)or normal group(control group,n=21)based on coronary angiography.Plasma specimens were obtained from proximal aorta during coronary angiography and detected for AngⅡ by radio-immunoassay and PAI-1 by enzyme-linked immunosorbent assay(ELISA).Inter-group differences and correlation between Ang II and PAI-1 were evaluated statistically.Results ①The levels of plasma AngⅡ and PAI-1 were respectively(46±11)pg/ml and(37±5)pg/ml(P<0.05)in coronary artery stenosis patients vs(26±8)ng/ml and(19±6)ng/ml(P<0.05)in normal controls;②The plasma PAI-1 level positively correlat-ed with the level of AngⅡ in patients with coronaty artery stenosis(r=0.46,P<0.05);③ Both the AngⅡ and PAI-1 levels in patients with three-vesselled stenosis were much more higher than those with single-vesselled lesion (52±7)pg/ml vs(38±11)pg/ml,P<0.05,AngⅡ];(35±15)ng/ml vs(21±7)ng/ml,P<0.01,PAI-1].Conclusion Our find-ings indicated high aortic plasma levels and significant correlation of Ang II with PAI-1 in patients with coronary stenosis,suggesting that disorders in the renin-angiotensin system and fibrinolytic system may interact and concurrently contribute to the development of coronary artery stenosis.