【摘要】 肾上腺髓质素(adrenomedullin,ADM)是1993年发现的一种新的血管活性多肽.本文观察轻、中度高血压患者血浆ADM(1-52)水平及药物干预后的变化,探讨ADM在高血压病中的作用.健康对照组19例,血浆 ADM水平为(20.97±1.81)ng/L.高血压病(EH)组26例,血浆ADM水平为(34.54±2.10)ng/L,Ⅰ期病人7例,ADM为(27.86±3.20)ng/L;Ⅱ期19例,ADM为(3.54±2.10)ng/L(P<0.05);EH病人血浆ADM水平与血浆血管紧张素Ⅱ(AGTⅡ)水平、动脉舒张压、动脉平均压(BMP)呈显著正相关(r分别为0.4904,P<0.05;0.4735,P<0.05和0.6081,P<0.01),而与心输出量、血肌酐及钾、钠、氯水平无明显相关.使用巯甲丙脯酸和硝苯吡啶治疗后,血浆ADM下降约10.7%(P<0.05)和 7.3%(P>0.05),AGT Ⅱ下降约10.8%(P<0.05)和6.3%(P<0.05),MBP降低2.9%(P<0.05)和 5.6%(P<0.05).结果显示:EH病人血浆ADM水平明显高于正常对照组,病情严重,ADM改变更明显;BMP、动脉舒张压及血浆AGT Ⅱ水平与血浆ADM水平密切相关,药物治疗后,伴随MBP和血浆AGTⅡ降低,ADM水平亦有不同程度的下降.EH病人血浆ADM水平升高可能是机体的代偿反应,血压和AGTⅡ可能与ADM的分泌及/或合成有关.药物治疗后的不同反应可能与药物的特性有关.更多还原

【Abstract】 We investigated the plasma level of ADM (1-52) in the patients with the essential hypertention (EH) and intervinient effects of the drugs to study the roles of ADM in EH. In the control group Gi=]9, average age 46. 21±2. 45) the plasma level of ADM was 20. 97±1. 81 ng/ L; in the patients group (n = 26, average age 47. 65 + 2. 00) the level was 34. 54?. 10 ng/L, a-mong them the level in stage Ⅰ (n= 7) was 27. 86±3. 20 ng/L> in stage Ⅰ (n=19) the level was 34. 54 + 2, 10 ng/L(/3<0. 05). The level of ADM in patietns was correlated with the plasma levels of angiotensin Ⅰ (ACT I )<diastolic blood pressure and mean blood pressurre(MBP) (r was 0. 4904, P<0. 05; 0. 4735, P<0. 05 and 0. 6081 P<0. 01). There were no correlationship between the plasma level of ADM and cardiac output,the serum level of creatinine and Na,K,Cl. After the treatment with captopril and nifedipine the plasma level of ADM decreased 10. 7%(P<0. 05) and 7. 3(P>0. 05), AGT Ⅱdecreased 10. 8% (P<0. 05) and 6. 3% CP<0. 05), MBP droped 2. 9%(P<0. 05) and 5. 6%(F<0. 05) respectively. The results showed that the plasma level of ADMwas high in the patients comparing with normal group and was higher in stage Ⅰ than stage Ⅰ . After the treatnent the concentration of ADM was decreased accompaning the reduction of MBP and AGT Ⅱ . These suggestes that the increase of plasma ADM in EH is compensating reactions, the blood pressure and AGT Ⅱ may stimulate the secretion or/and synthesis of ADM. The different effects of the treatment may be referred to the character of the drugs.更多还原