Study On The Correlation And Express Of Vasoactive Peptides Such As Adrenomedullin To The Acute And Chronic Injury Of Coronary Artery Endothelium

Objective To study the change of ADM and ET-1 levels in patients who had different risk factors, different coronary artery stenosis, different endothelin stability and after interventional treatment, meanwhile discuss the relationship and clinical meaning between the vasoactive peptides levels and acute, chronic endothelin injury. Methods 72 CHD patients were recruited: firstly, They were divided into ABC group according to their acumulation of risk factors; Secondly, They were divided into SAP and UAP group; Thirdly, the low degree, the medium degree and the high degree group. Eighteen normal prople were used as conterels. Finaly, 28 patients with coronary heart disease and received PTCA and stent implantation were compared with the patients who only received CAG. The levels of plasma ADM, ET-1 were determind by radioimmunoassay before and after PTCA and CAG.Results (1)Except to the levels of ADM in A group (p>0.05), The plasma ADM, ET-1 increased significantly in A, B, C group (p<0.01) compared to the control group(D). There were significant differences in the levels of ADM, ET-1 among the A B C group (p<0.01) .It suggest that the more risk foctors the more sverely injury of endothelin (2)There were positive correlations between the levels of ADM ET-1 and the degree of coronary artery stenosis. The levels of ADM ET-1 were significant hige in the medium degree and the hige digree group compared to the control group (p< 0.01). In stenosis subjects there were significant differences among the three group (p <0.01) .(3)The levels of ADM, ET-1 in UAP group were significant differences hige than SAP group and control group (p<0.01) .but there were no significant differences between SAP group and control group (p>0.05).(4)The levels of ADM ET-1 increased significantly affter receiving PTCA than before PTCA (p<0.01) .but there were no significant change in CAG (p>.05).(5) There were positive correlations between the levels of plasma ADM and ET-1 (r=0.850, p<0.01).Conclusions (1)The chronic injury of risk factors to the endothelin is accumulated. The more risk factors the higer injury to the edothelin.(2)The levels of ADM ET-1 is corelated with the degree and numbers of vessel disease. They could be used as the marker for severity of coronary artery injurys. (3)Different kind of angina pectoris has different levels of ADM and ET-1. The levels of ADM and ET-1 in UAP was higer than that of in SAP. So it could be used as the standard for differentiate angina pectoris. (4) PTCA may stimulate the release of vasoactive peptide. Therefore, effectively controlling the risk factor and correcting the dysfunction of the endothelium are the important therapeutic steps and methods in preventing the restenosis and chronic injury of coronary endothelium. (5)The levels of ADM and ET-1 are corelated. They are the marker for endothelial injury.