【摘要】 目的研究风湿性二尖瓣狭窄 (MS)病人行二尖瓣球囊扩张术 (PBMV)前后外周静脉血浆中肾上腺髓质素 (ADM)浓度及其与血流动力学参数间的关系。方法用放射免疫法测定 2 0例MS病人和 1 2例正常对照组静脉血浆ADM浓度 ,同时用超声心动图测量 2 0例MS病人血液动力学参数。结果术前MS组血浆ADM含量明显高于正常对照组 (P <0 .0 1 ) ,术后则显著下降 (P <0 .0 1 ) ,但仍明显高于对照组 (P <0 .0 1 ) ;术前血浆ADM浓度与平均左房压 (MLAP)和平均跨二尖瓣舒张期压差 (DMTG)均显著正相关 (r=0 .76 ,P <0 .0 1和r=0 .6 5 ,P <0 .0 1 ) ,术前后血浆ADM浓度与相应的DMTG显著正相关 (r=0 .85 ,P <0 .0 1 )。结论ADM参与MS的病理生理过程 ,其血浆水平可为判断MS严重程度及PBWV疗效的敏感指标。更多还原

【Abstract】 Objectives To investigate the changes of plasma adrenomedullin (ADM)levels before and after percutaneus balloon mitral valvuloplasty (PBMV)in patients with mitral stenosis (MS) and the correlation between plasma ADM levels and hemodynamic parameters.Methods Plasma ADM levels were determined by radioimmunoassy in 20 patients with MS and 12health control subjects.In 20 patients with MS,the hemodynamic parameters were measured by echo cardiography and record.Results The plasma ADM levels were significantly higher in patients with MS than that in control subjects (64.8±2.9ng/L vs.21.3±2.3ng/L,P<0.01)before PBMV and decreased remarkably after PBMV (48.3±2.7ng/L,P<0.01),but significant higher than that in control subjects (P<0.01),there was a sigificant correlation between plasma ADM levels and MLAP (r=0.76,P<0.01)and DMTG(r=0.65,P<0.01)before PBMV.There was a significant correlation between plasma levels of ADM and DMTG before and after PBWV.Conclusion These results suggest that ADM may play a certain role in the pathophysiology of MS.Before and after PBMV,the plasma ADM levels may be a valuable maker for vealuating the severity of MS and the effect of PBMV.更多还原