Patients With Coronary Heart Disease Of Plasma Et, No, Camp And Cgmp Levels And Clinical Significance

Background: Unstable angina pectoris(UAP)is a intermidiate state of stable angina pectoris(SAP)and acute myocardial infarction(AMI). It can revert to SAP and develop to AMI in short time. Its pathological mechanism is multiple:①Coronary atherosclerosis and coronary stenosis;②Injured coronary endothelia function and unbalanced vasoactivatoris cause coronay constriction and coronary vasospasm;③Plaque rupture and substrates exposure induce platelet activation,adherence,aggregationand lead to thrombosis.When coronary vasospasm and intracoronary thrombosis occlud coronary artery partly and intermittently,the clinical manifestation is UAP. Otherwise when coronary artery is occluded totally for a relatively long time, the clinical manifestation is AMI.Objective: To observe the plasma ET,NO,cAMP and cGMP concentration changes in patients with SAP,UAP and AMI.Explore their significance in the pathogenesis of UAP and AMI.Methods: Plasma concentration of ET,NO,cAMP and cGMP was measured respectively in 23 AMI patients,48UAP patients,28SAP patients and 26 control cases.Difference of the above parameters between each two groups was analyzed.Results: 1.①Plasma ET concentration of UAP group,SAP group and AMI 1st day group,AMI 14th day group was significantly higher respectively than control group(P<0.01 respeltively).②Plasma ET concentration of UAP group,AMI 1st day group was significantly higher respectively than SAP group(P<0.01 respectively).③Plasma ET concentration of AMI 1st day group was significant higher than UAP group(P<0.01).④There was no significant difference in plasma ET concentration between AMI 14th day group and SAP group(P>0.05). ⑤Plasma ET concentration of AMI 1st day group and UAP group was significantly higher respectively than AMI 14th day group (P<0.01 respectively).2. ①Plasma NO concentration of UAP group,SAPgroup,AMI 1st day group and AMI 14th day group was significantly reduced than control group (P<0.01 respectively); ②Plasma NO concentration of UAP group and AMI 1st day group was significantly reduced than SAP group(P<0.01 respectively);③Plasma NO concentration of AMI 1st day group was significantly reduced than UAPgroup(P<0.05);④There was no significantly difference in plasma NO concentration between AMI 14th day group and SAP group (P>0.05).⑤Plasma NO concentration of UAP group and AMI 1st day group was significantly reduced than AMI 14th day group (P<0.01 respectively)3. ①There was no significant difference in plasma cAMP concentration between UAP group,SAP group,AMI 1st day group and control group(P>0.05 respectively).②Plasma cAMP concentration of AMI 14th day group was significantly reduced than the control group,UAP group,SAP group and AMI 1st day group(P<0.01 respectively).③There was no significant difference in plasma cAMP concentration between SAP group,UAP group and AMI Ist day group(P>0.05 respectively).④There was no significant difference in plasma cAMP concentration between UAP group and AMI 1st day group(P>0.05).4.①Plasma cGMP concentration of AMI 1st day group,AMI 14th day group,UAP group and SAP group was significantly higher respectively than control group (P<0.01 respectively).②There was no significant difference between AMI Ist day group,AMI 14th day group and SAP group in plasma cGMP concentration(P>0.05 respectively).③Plasma cGMP concentration of UAP group was significantly higher than AMI 1st day group,AMI 14th day group and SAP group respectively(P<0.01 respectively).④There was no significant difference between AMI lst day group and 14th day group in plasma cGMP concentration(P>0.05).Conclusion: On the basis of coronary atherosclerosis. Increased ET or reduced NO can induce coronary vasospasm.Meanwhile,increased cGMP and reduced cAMP of coronary heart disease (CHD)patients cause platelet activation,adherence and aggregation which induce intracoronary thrombosis. Coronary vasospasm and intracoronary thrombosis are the principle pathological mechanisms of UAP and AMI.ET, NO,cAMP and cGMP play an important rol...