稳定型和不稳定型心绞痛患者血浆内皮素的改变及钙拮抗剂对其影响

目的：探讨冠心病心绞痛发病中内皮素（ET）的作用及钙拮抗剂对冠心病心绞痛患者血浆ET水平的影响。方法：采用放免法测定35例稳定型心绞痛（SA组）、30例不稳定型心绞痛（UA组）及30例健康人（对照组）血浆ET含量，同时测定34例口服硝苯吡啶、24例口服地尔硫患者用药15d后血浆ET含量。结果：UA组血浆ET含量明显高于SA组（P＜0．001），两组均高于对照组（均P＜0．001），硝宋吡啶、地尔硫草均能降低冠心病患者血浆ET水平（与治疗前相比P＜0．001），其中硝苯毗院作用尤为显著，治疗后患者血浆ET水平降至正常（与对照组相比P＞0．05），地尔硫革尚不能使冠心病患者血浆ET水平降至正常（与对照组相比P＜0．001）。结论：ET在冠心病心绞痛的发病中有重要作用，钙桔抗剂硝本毗埃、地尔硫均能降低心绞痛患者血浆ET水平，前者作用强手后者。

Effect of calcium antagonist on the plasma endothelin level in patients with stable and unstable angina

Objective:To examine the effect of plasma endothelin(ET) on pathogenesis of stable and unstable angina and to assess the effect of calcium antagonist on the plasma ET level in them. Methods:The plsama ET levels were measured by radioimmunoassay in 35 patients with stable angina (SA group), 30 patients with unstable angina (UA group) and 30 normal control subjects. The plasma ET levels after 15 days in 34 patients treated by nifedipine and 24 patients treated by diltiazem were also measured. Results:The plasma ET levels were higher in the UA group than those in SA group and were higher in both angina groups than those in control group (P < 0.001). The plasma ET level decreased after 15 days of nifedipine treatment as well as of diltiazem treatment (P <0.001). Particularly after nifedipine teatment,the ET level decreased more significantly (compared with that in control group, P >0.05) and nearly returned to normal. After diltiazem treatment,the ET level was still higher than that of control group (P <0. 001). Coedusion:The results demonstrated that endothelin played an important role in pathogenesis of angina. Calcium antagonist could reduce the plasma ET level significantly. The effect of nifedipine was stronger than of diltiazem.