慢性萎缩性胃炎患者血浆cAMPcGMP水平的变化

目的本文旨在研究慢性萎缩性胃炎患者脾气虚证与血浆ｃＡＭＰ与ｃＧＭＰ的关系．方法对８７例萎缩性胃炎有脾气虚证者以碘１２５标记的ｃＡＭＰ与ｃＧＭＰ药盒采用免疫化学法测定其血浆ｃＡＭＰ与ｃＧＭＰ，其中３０例在萎胃安冲剂１—２疗程前后作自身对照，观察其血浆浓度变化．结果所有脾气虚证的萎缩性胃炎患者，血浆ｃＡＭＰ与ｃＧＭＰ分别为低与正常低限．３０例萎胃安冲剂治疗者，其血浆ｃＡＭＰ与ｃＧＭＰ均较治前增高，Ｐ值分别为＜００１与＜００５，有统计学意义．结论对萎缩性胃炎脾气虚患者，测定其血浆ｃＡＭＰ与ｃＧＭＰ水平有重要意义．萎胃安冲剂可改善其症状，纠正血浆ｃＡＭＰ低下状态．     

慢性肺心病患者血浆内皮素-1、环磷酸鸟苷与肺血流动力学的关系及硝普钠对其的影响

对１８例慢阻肺缓解期和２０例肺心病急性发作期患者行血浆ＥＴ－１（内皮素－１）、ｃＧＭＰ（环磷酸鸟苷）放免测定并同时行血流动力学、ＰａＯ２检测及硝普钠治疗观察。结果发现，肺心病患者血浆ＥＴ－１水平显著高于慢阻肺患者，并与ＰＡＰＭ、ＰＶＲ呈显著正相关，与ＰａＯ２显著负相关。血浆ＥＴ－１水平的增加同时伴随血浆ｃＧＭＰ水平继发性的增加，两者呈显著正相关。硝普钠治疗后血浆ｃＧＭＰ水平显著增加，而血浆ＥＴ－１水平无明显变化。提示：缺氧性肺动脉高压不仅使血浆ＥＴ－１水平增加，同时伴随血浆ｃＧＭＰ继发性增加。ＥＴ－１／ｃＧＭＰ比值可能对肺循环压力的调节起着重要作用。     

红细胞抗高血压因子和川芎嗪对大鼠血管平滑肌cGMP含量的影响

观察红细胞抗高血压因子（ＡＨＦ）和中药川芎嗪（ＴＭＰ）对血管平滑肌细胞环一磷酸鸟苷（ｃＧＭＰ）产生的影响。方法实验用８～１０周的Ｗｉｓｔａｒ大鼠（ｎ＝６）。分离主动脉（Ａ）及肠系膜动脉（ＭＡ），其中Ａ一半去内皮，另一半保留内皮完整，将肌条分别制备成匀浆，用放射免疫分析法测定ｃＧＭＰ含量。结果ＡＨＦ（１０－５ｇ／ｍｌ）和ＴＭＰ（１０－４ｍｏｌ／Ｌ）对血管平滑肌细胞（ＶＳＭＣ）ｃＧＭＰ生成有显著刺激作用。在ＡＨＦ作用下，Ａ组有、无内皮组和ＭＡ组ｃＧＭＰ含量分别是对照组的１．２５倍，１．２６倍和１．７２倍；在ＴＭＰ作用下的实验组ｃＧＭＰ含量分别为对照组的１．６０倍，１．５０倍和１．５２倍，与对照组比较差异均有显著性（Ｐ＜０．０５或Ｐ＜０．００１）。结论ＡＨＦ和ＴＭＰ均能升高Ａ和ＭＡｃＧＭＰ水平，且ＡＨＦ对阻力血管的影响明显高于容量血管，而ＴＭＰ对两种血管的ｃＧＭＰ水平影响无明显差异，ＡＨＦ与ＴＭＰ对血管ｃＧＭＰ的增高作用似乎与内皮无关。     

高氟摄入后大鼠骨骼肌环核苷酸的变化及镁硒的影响

雄性Ｗｉｓｔａｒ大鼠腹腔ＮａＦ实验表明，亚急性氟中毒大鼠肌骼肌组织环磷酸腺苷（ＣＡＭＰ）水平明显市长中，环磷酸鸟苷（ＣＧＭＰ）水平下降，ＣＡＭＰ／ＣＧＭＰ升高。加镁后，由于ＣＧＭＰ水平升高，使ＣＡＭＰ／ＣＧＭＰ下降，这一作用可能与镁拮抗指一有关。而硒对这一生理过程无明显影响。     

温胃舒冲剂对小鼠慢性萎缩性胃炎的保护作用及其机理初探

温胃舒冲剂是根据临床实践组成的中药复方制剂．为了探讨其作用机理．用小鼠造成３种模型：去氧胆酸钠（ＤＯＣＡ）造成慢性萎缩性胃炎（ＣＡＧ）模型；ＤＯＣＡ＋甲疏基咪唑造成 ＣＡＧ－阳虚模型，ＤＯＣＡ＋甲状腺＋利血平造成 ＣＡＧ－阴虚模型。以血浆中环磷酸腺苷（ｃＡＭＰ ）、环磷酸鸟苷（ｃＧＭＰ）观察其治疗作用。结果表明，温胃舒能降低ＣＡＧ模型小鼠的ｃＡＭＰ、ｃＧＭＰ．也能降低ＣＡＧ－阳虚模型小鼠的ｃＧＭＰ，与模型对照组比较均Ｐ＜０．０５～０．０１。此外．结果还表明温胃舒冲剂有镇痛、抗炎和抑制胃肠推进运动、并能提高大鼠淋巴细胞转化率、血清ＩｇＧ水平。     

急性脑梗塞患者血浆cAMP和cGMP的含量变化及其临床意义

用放射免疫分析法对８４例急性脑梗塞患者（脑梗塞组）及６０例同龄健康者（对照组）的血浆环磷酸腺苷（ｃＡＭＰ）和环磷酸鸟苷（ｃＧＭＰ）含量进行了测定。结果显示，脑梗塞组血浆ｃＡＭＰ和ｃＧＭＰ含量及其比值均低于对照组，ｃＡＭＰ降低明显（Ｐ〈０．０１），ｃＧＭＰ降低轻微（Ｐ〉０．０５），其ｃＡＭＰ含量降低及ｃＡＭＰ／ｃＧＭＰ比值减小与病情呈正相关，提示检测血浆ｃＡＭＰ和ｃＡＭＰ含量有助于判断脑梗塞病情，指     

肺结核病人外周血淋巴细胞化学发光改变

采用液闪单光子辐射法检测肺结核病人进展期和稳定期外周血淋巴细胞的化学发光，同时检测血浆相关性介质环磷酸腺苷（ｃＡＭＰ）、环磷酸鸟苷（ｃＧＭＰ）、超氧化物歧化酶（ＳＯＤ）水平。结果显示，活动期肺结核病人淋巴细胞基础发光显著增强，植物血凝素（ＰＨＡ）所诱导的最大发光显著减弱。血浆相关性指标ｃＡＭＰ和ＳＯＤ下降，ｃＧＭＰ上升。上述指标在稳定期肺结核病人已与正常对照无显著差异。结果提示肺结核活动期淋巴细胞     

肺结核病人外周血淋巴细胞化学发光改变

采用液闪单光子辐射法检测肺结核病人进展期和稳定期外周血淋巴细胞的化学发光，同时检测血浆相关性介质环磷酸腺苷（ｃＡＭＰ）、环磷酸鸟苷（ｃＧＭＰ）、超氧化物歧化酶（ＳＯＤ）水平。结果显示，活动期肺结核病人淋巴细胞基础发光显著增强，植物血凝素（ＰＨＡ）所诱导的最大发光显著减弱。血浆相关性指标ｃＡＭＰ和ＳＯＤ下降，ｃＧＭＰ上升。上述指标在稳定期肺结核病人已与正常对照无显著差异。结果提示肺结核活动期淋巴细胞预激活水平增高，处过度变态反应状态，激活反应能力下降，细胞免疫功能低下。     

GRH调节的AC－cAMP系统对垂体生长激素瘤发病机制中的影响

在２１例体外培养的人生长激素（ＧＨ）瘤细胞研究了生长激素释放激素（ＧＲＨ）对细胞内ｃＡＭＰ水平与ＧＨ分泌的影响和腺苷酸环化酶－环磷酸腺苷（ＡＣ－ｃＡＭＰ）系统激动剂霍乱毒素（ＣＴ）、Ｆｏｒｓｋｏｌｉｎ和双丁酰ｃＡＭＰ（ｄｂｃＡＭＰ）对ＧＨ分泌的凋节作用及其相互关系。结果显示：分别有６１．９％（１３／２１）和５７．１／（１２／２１）的患者ＧＨ瘤细胞的ＧＨ分泌对ＧＲＨ和ＣＴ的刺激个敏感；而Ｆｏｒｓｋｏｌｉｎ和ｄｂｃＡＭＰ可使８８．９％（８／９）和１００％（５／５）患者的垂体瘤细胞ＧＨ分泌显著增加（Ｐ＜０．０５）；在９例瘤细胞中有４例ＧＲＨ可使细胞内ｃＡＭＰ水平升高至对照的１３４．２％～７２４．３％（Ｐ＜０．０５），在另５例ＧＲＨ对ｃＡＭＰ水平无影响。以上结果说明，多数ＧＨ瘤细胞存在着ＧＲＨ受体和（或）受体后鸟苷酸调节蛋白     

糖尿病血浆GMP—140和血小板聚集功能的临床意义

目的：探讨非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者血小板颗粒膜糖蛋白－１４０（ＧＭＰ－１４０）和血小板聚集功能的临床意义。方法：用酶联免疫吸附双抗体夹心法测定ＮＩＤＤＭ患者血浆ＧＭＰ－１４０和ＰＡＧＭ水平，与对照组比较。结果：ＮＩＤＤＭ患者ＧＭＰ－１４０、ＰＡＧＭ均高于对照组。同时合并微血管病变的患者血浆ＧＭＰ－１４０和ＰＡＧＭ较无微血管病变者明显增加．２５例合并微血管病变的ＮＩＤＤＭ患者２￣４周治     

The prognostic significance of plasma cyclic nucleotides in patients with congestive heart failure]

The relationship between plasma levels of cyclic nucleotides and mortality was studied in 108 patients with congestive heart failure (CHF) in whom plasma cAMP and cGMP, were determined by radioimmunoassay and were followed-up for 36 to 48 months. 29 patients died. The plasma concentrations of cAMP and cGMP in the dead group were significantly higher than those in the survival group (27.41 +/- 6.11 and 31.11 +/- 18.23 vs 21.56 +/- 5.37 and 17.45 +/- 9.35 nmol/L, respectively, mean +/- s, P < 0.001). Compared with patients with cAMP concentrations below the median value of 22.31 nmol/L, those with higher levels of cAMP had a higher mortality rate (46.3% vs 7.4%, P < 0.001). Patients with cGMP levels above the median value of 17.24 nmol/L also had a higher mortality rate than those with lower levels (40.7% vs 13.0%, P < 0.01). Multivariate stepwise regression analysis including age, cardiac function classification, heart rate, serum potassium and sodium, plasma cAMP, cGMP and cAMP/cGMP was carried out and revealed that only plasma cAMP and cGMP could provide independent prognostic information. Thus plasma levels of cyclic nucleotides was considered the excellent predictor for patients with CHF.     

Uncoupling of atrial natriuretic peptide extraction and cyclic guanosine monophosphate production in the pulmonary circulation in patients with severe heart failure.

OBJECTIVES. This study was designed to evaluate the role of endogenous atrial natriuretic peptide in the pulmonary circulation in patients with chronic heart failure. BACKGROUND. Plasma atrial natriuretic peptide concentrations in patients with heart failure have been reported to be higher than those in normal subjects and to increase as the severity of heart failure progresses. Although endogenous atrial natriuretic peptide is thought to improve the condition of patients with heart failure by reducing preload and afterload, recent findings have indicated that a high plasma atrial natriuretic peptide level is a prognostic predictor in patients with heart failure. METHODS. To evaluate the pathophysiologic role of endogenous atrial natriuretic peptide in the pulmonary circulation, plasma atrial natriuretic peptide and cyclic guanosine monophosphate (cGMP) levels were determined in the main pulmonary artery and pulmonary capillary wedge region in 80 patients with chronic congestive heart failure (New York Heart Association functional classes II to IV). RESULTS. The plasma atrial natriuretic peptide level decreased significantly from the main pulmonary artery to the pulmonary capillary wedge region, whereas the plasma cGMP level increased significantly from the main pulmonary artery to the pulmonary capillary wedge region. In patients with mild chronic heart failure (n = 50), the plasma atrial natriuretic peptide level correlated with the cGMP level in the main pulmonary artery (gamma = 0.71, p less than 0.001). The atrial natriuretic peptide extraction level, calculated as (Atrial natriuretic peptide in the main pulmonary artery--Atrial natriuretic peptide in the pulmonary capillary wedge region) x Cardiac output x (1-hematocrit/100) (ng/min), also correlated with the cyclic guanosine monophosphate production level, calculated as (cGMP in the pulmonary capillary wedge region--cGMP in the main pulmonary artery) x Cardiac output x (1-hematocrit/100) (nmol/min) (gamma = 0.78, p less than 0.001). In contrast, such correlations were not found in patients with severe chronic heart failure (n = 30). In these patients, the atrial natriuretic peptide extraction level was significantly higher but there was no significant difference in the cGMP production level between the two groups (mild and severe chronic heart failure). Therefore, the molar ratio of cGMP production to atrial natriuretic peptide extraction in the pulmonary circulation was significantly lower in patients with severe chronic heart failure (88 +/- 16 vs. 480 +/- 41, p less than 0.001). CONCLUSIONS. These results indicate that down-regulation of atrial natriuretic peptide receptors coupled to guanylate cyclase may occur in the pulmonary vascular beds of patients with severe chronic heart failure.     

脑钠肽结合超声多普勒评价舒张性心力衰竭患者的心功能

目的 采用血浆脑钠肽(BNP)浓度测定结合超声多普勒心动图的参数来评价舒张性心力衰竭患者的心功能,为临床提供判断舒张性心力衰竭及其严重程度的敏感和特异的客观指标.方法 选择舒张性心力衰竭患者85例(心力衰竭组),按纽约心脏病学会(NYHA)心功能分级,Ⅱ级31例、Ⅲ级36例、Ⅳ级18例,以及健康对照组30例.测定血浆BNP浓度,超声多普勒结合组织多普勒显像(TDI)测定左室结构、左室舒张功能及左室舒张末压.结果 舒张性心力衰竭患者血浆BNP浓度明显高于对照组(P<0.001),且随心力衰竭程度加重而逐渐升高(P<0.001).舒张性心力衰竭组左房内径(LA)、室间隔厚度(IVS)、左室后壁厚度(LVPW)、舒张早期流速峰值/舒张早期速度峰值(E/Em)较对照组升高,E/舒张晚期流速峰值(A)降低(P<0.01),血浆BNP浓度与E/A比值呈负相关(r=-0.634,P<0.01),与E/Em比值呈正相关(r=0.728,P<0.01).结论 血浆BNP浓度测定结合超声多普勒心动图的参数判断舒张性心力衰竭患者的心功能简便准确.     

美托洛尔对心衰患者?受体相关信号通路及心功能的影响

目的 探讨?1受体阻滞剂美托洛尔对慢性心力衰竭病人?受体相关信号通路及心功能的 干预机制。方法 选择慢性心功能不全病人95例，随机分为常规治疗组（45例）和美托洛尔治疗组（50例），美托洛尔逐渐递增至最大剂量（100mg，每日2次）或最大耐受剂量。半年后复查彩色多普勒心动图左心室舒张末内径（LVEDD）、左心房内径（LAD）、左室射血分数（LVEF）和心胸比例（CTR），RT-PCR检测血淋巴细胞肾上腺素能?1、 ?2、?3受体mRNA表达，复查血浆环磷酸腺苷（cAMP）、环磷酸鸟苷（cGMP）、一氧化氮合酶（NOS）、诱导型一氧化氮合酶（iNOS）和一氧化氮（NO）含量。结果 美托洛尔治疗组及常规治疗组6月后，心衰患者心功能明显改善，LVEF升高。美托洛尔治疗组CTR、LVEDD和LAD明显减少，美托洛尔治疗组cAMP、cGMP、NOS、iNOS和NO含量明显降低。结论 美托洛尔通过调节?受体相关信号通路，改善慢性心功能不全患者的心功能。     

Changes in thrombocyte-vascular hemostasis and cyclic nucleotide levels after anti-arrhythmia therapy in patients with ischemic heart disease

Platelet-vascular hemostasis and cyclic nucleotide levels as well as the effects of mexitil, ritmilen and prolecofen on those were examined in 58 coronary patients with various heart rhythm disorders. The patients showed considerably increased platelet activity, low prostacyclin level and high thromboxane and cyclic nucleotides levels, particularly in patients with high-grade ventricular extrasystoles. Mexitil did not essentially affect the parameters in question. Ritmilen produced a significant increase in 6-keto-PGF1 alpha and a decrease of platelet activity. In prolecofen-treated patients, platelet activity decreased significantly, cAMP and cGMP dropped while the cAMP/cGMP ratio went up; prostacyclin and thromboxane changes were not significant. This may be a mechanism of prolecofen's antiarrhythmic action.     

Ergometric exercise testing and sensitivity of cyclic guanosine 3',5'-monophosphate (cGMP) in diagnosing asymptomatic left ventricular dysfunction.

OBJECTIVE--Increased plasma concentrations of cyclic guanosine monophosphate (cGMP) have been reported in patients with manifest heart failure. At rest, however, cGMP concentrations in patients with asymptomatic left ventricular dysfunction or heart failure in New York Heart Association (NYHA) functional class I do not differ significantly from those of healthy subjects. The purpose of this study was to investigate whether graded exercise on an ergometer improves the sensitivity of cGMP in diagnosing asymptomatic left ventricular dysfunction. PATIENTS--Plasma cGMP concentrations were compared in 17 healthy controls and 98 patients with asymptomatic left ventricular dysfunction or congestive heart failure of different stages (asymptomatic left ventricular dysfunction or NYHA functional class I, 56 patients; NYHA class II, 31 patients; NYHA class III, 11 patients). RESULTS--Before exercise plasma cGMP concentrations in patients with clinical heart failure (NYHA functional classes II and III) were significantly higher than those in healthy controls. In patients with asymptomatic left ventricular dysfunction or heart failure of functional class I plasma cGMP concentrations were not significantly different from those in healthy subjects. Thirty minutes after exercise, however, cGMP concentrations in patients with asymptomatic left ventricular dysfunction or class I heart failure were significantly higher than those in healthy controls. CONCLUSION--Measurement of plasma cGMP concentrations 30 minutes after ergometric exercise testing allows better discrimination between healthy subjects and patients with symptomless left ventricular dysfunction or mild heart failure (NYHA class I) than measurement of such concentrations before exercise.     

Plasma and urine cyclic nucleotide levels in patients with acute and chronic leukemia

Plasma and urine levels of cyclic adenosine 3',5'-monophosphate (cAMP) and of cyclic guanosine 3',5'-monophosphate (cGMP) were measured in 35 normal subjects, in 24 patients with nonneoplastic diseases (iron deficiency anemia, peptic ulcer, and cholelithiasis), and in 50 leukemic patients. The leukemic group included patients with acute lymphoblastic leukemia, acute myelogenous leukemia, chronic lymphocytic leukemia, and chronic myelogenous leukemia. All patients were recently diagnosed and untreated, except for 5 patients with blastic transformation of chronic myelogenous leukemia who had been previously treated. There were no significant differences in plasma and urine cyclic nucleotide levels between normal subjects and patients with nonneoplastic diseases. In leukemic patients, plasma and urine cAMP levels were similar to those of normal subjects, whereas plasma and urine cGMP levels were markedly elevated. There were no significant differences in cGMP values between the various types of leukemia. After starting treatment, plasma cyclic nucleotide levels were periodically measured in 21 of the patients with acute leukemia; cGMP levels were normalized in all the 16 subjects who attained complete remission, whereas both cAMP and cGMP levels were apparently unaffected in the patients who did not respond to treatment. This suggests that plasma or urine cGMP could be used as an additional parameter to monitor the patient's response to treatment.     

Dynamics of the cyclic nucleotide content in the acute period of myocardial infarct

Developing myocardial infarction is shown to be accompanied by raised plasma cAMP and cGMP levels which peak within the first few hours of the disease. Two patterns of changes were noted in the content of cyclic nucleotides: cAMP increase prevailing (a more typical pattern) and cGMP increase prevailing. Primary ventricular fibrillation was recorded in some patients belonging to the latter group. The development of cardiac failure is accompanied by a more stable rise of plasma cAMP.     

Effect of a glucose-insulin-potassium mixture on the cyclic and adenine nucleotide levels in the acute period of myocardial infarct

The development of myocardial infarction was shown to be accompanied by a rise in blood cAMP, cGMP and AMP levels, cyclic nucleotides peaking within the first hours of the disease. The increase in plasma cAMP, associated with developing heart failure, was more persistent. The administration of GIP mixture during the acute phase of myocardial infarction was conducive to lowering the levels of cyclic nucleotides and AMP, and raising blood ATP and ADP values. Clinically, the effect of GIP was manifested in reduced ventricular arrhythmias and diminished signs of heart failure.     

Plasma cyclic nucleotide levels in patients with refractory anaemia with excess of blasts

Summary To verify the clinical usefulness of extracellular cyclic nucleotide determinations as tumour markers in preneoplastic syndromes, plasma cyclic AMP (cAMP) and cyclic GMP (cGMP) levels were monitored in 47 patients with refractory anaemia with excess of blasts (35 RAEB and 12 RAEBt), 20 of whom progressed to acute leukaemia during the observation period. The control group consisted of 45 healthy subjects matched for age and sex. In all groups of patients plasma cAMP levels were within the normal range, whereas plasma cGMP levels were significantly higher than those of normal subjects in both RAEB and RAEBt patients, and increased further when progression to acute leukaemia occurred. These data suggest that serial determinations of plasma cGMP may be useful to monitor the progression of the disease, though there is no evidence that cGMP values at diagnosis may have a prognostic significance.