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1、哮喘患者血浆肾上腺髄质素和内皮素水平的变化及临床意义作者:仝金斋,张孔,左万里,梁丽萍作者单位:(屮山大学附属江门医院,广东江门529000;中山大学第一附属医院,广州510080)【摘要】1=1的观察哮喘患者血浆肾上腺髓质素(adrenomedullin,ADM)a
2、A&素(endothelin,ET)水平的变化,探讨ADM、ET在哮喘发病屮的作用及临床意义。方法选择轻、屮度哮喘患者47例作为研究对彖,其中急性发作期患者24例,缓解期23例,并以健康成人15例作为对照组,采用放射免疫的方法测定血浆ADM和ET水平,同时
3、检测患者肺通气功能。结果哮喘急性发作期患者血浆ADM、ET水平明显高于缓解期患者和健康人(P0.05),而哮喘缓解期患者血浆ADM、ET水平均较健康人稍增高,但无统计学意义(P0.05)o哮喘急性发作期ADM与ET呈正相关(r=0.614,P=0.0010.05),哮喘急性发作期ADM、ET均与FEV1%pre呈负相关(N二0.629,P0.01;「2二0.574,P0.05)。结论血•浆ADM、ET水平与哮喘发病有一定关系,ADM、ET水平对哮喘患者病悄严重程度的评价具有一定意义。【关键词】哮喘;肾上腺髓质素;内皮素;
4、肺功能PlasmalevelsandclinicalsignificaneeofadrenomedullinandendothelininasthmapatientsTONGJinzhai,ZHANGKong,ZUOWanIi,LIANGLiping(TheCentralHospitalofJiangmenCity,Jiangnien529000,China;TheFirstAffiliatedHospital,SunYatsenUniversity,Guangzhou510080,China)Abstract:Obje
5、ctiveToobservethechangesofplasmalevelsofadrenomcdullin(ADM)andendothelin(ET)andanalyzetheclinicalsignificanceofthechangesinasthmapatients.47casesofmildormoderateasthmaticwereenrolledinthisstudy,amongwhich,23patientswerestableand24withanacuteattack・TheplasmaADMand
6、ETconcentrationsweremeasuredbytheradioimmunoassaywithcommercialkits.Thepulmonaryfunctionsweremeasuredwithspirometers.ResultsTheplasmaADMandETconcentrationsinpatientswithanacuteattackweremarkedlyhigherthanthatinthestablepatients(P0.05).AlthoughboththeADMandETmeanc
7、oncentrationsinstablepatientswereslightlyhigherthanthatinnormalsubjects,theydidnotshowanystatisticalsignificance(P0.05).TherewasapositivecorrelationbetweenplasmasADMandETlevelsinacuteasthmaticpatients(「=0.614,P=0.001),butnoinstablepatientsandnormalsubjects.Plasma
8、ADMlevelin16acuteasthmaticpatientswasnegativelycorrelatedwithFEV1%pre(r=-0.629P0.01).PlasmaETlevelsinasthmaticpatientswereinverselycorrelatedwithFEV1%pre(r=-0.574,P0.05).ConclusionADMandETplasmalevelsmightnotbevaluableofdiagnosisofasthma,butmightbecorrelatedwitht
9、hedeteriorationofasthma,thusmaybeusedinmonitoringasthma.Keywords:asthma;adrenomedullin;endothelin;pulmonaryfunction肾上腺髓质素(ADM)是近年发现的一种血管活性肽,它广泛分布在人体内血管、肺、支气管、肾