Mangiafico R A, Malatino L S, Spada R S, Santonocito M, Messina R, Dell'Arte S, Attinà T
Institute of Clinica Medica L Condorelli, University of Catania, Italy.
Int Angiol. 2000 Mar;19(1):14-7.
Endothelin-1 (ET-1) is an endothelial vasoconstrictor mitogenic peptide which is thought to be a marker of endothelial damage and a potential participant in the pathophysiological processes of the development of atherosclerotic lesions and disease states associated with vasoconstriction and vasospasm.
To investigate the endothelin-1 release in response to dynamic exercise in patients with peripheral arterial occlusive disease (PAOD), plasma concentrations were determined by radioimmunoassay in 16 patients (14 men, 2 women, mean age 56.2 +/- 8.1 years) with peripheral arterial occlusive disease at Fontaine stage IIb and in 10 control subjects (8 men, 2 women, mean age 58.1 +/- 7.2 years) in normal health during treadmill testing (slope 5%, speed 3 km/hr). Blood samples were collected at rest from an antecubital vein, at the onset of claudication pain, and 10 minutes after exercise.
Mean plasma endothelin-concentrations during the stress test increased significantly in the patients with arterial disease, rising from basal values of 4.4 +/- 0.6 pmol/L to values of 8.9 +/- 0.7 pmol/L at the end of the test (p < 0.0001), whereas it did not change significantly in control subjects (rising from 2.6 +/- 0.4 pmol/L to 2.7 +/- 0.5 pmol/L). Further, plasma endothelin- in the patients with arterial disease was at all times higher than in the control subjects (p < 0.0001).
In conclusion, this study shows that in patients with peripheral arterial occlusive disease, plasma endothelin-1 increases after treadmill exercise performed until claudication pain supervenes. Raised endothelin-1 could be a marker of ischaemic acute endothelial damage and/or could contribute to increase the vascular resistance in ischaemic limbs of these patients during dynamic exercise by promoting arterial/arteriolar vasoconstriction or vasospasm.
内皮素 -1（ET -1）是一种内皮血管收缩促有丝分裂肽，被认为是内皮损伤的标志物，并且是动脉粥样硬化病变发展以及与血管收缩和血管痉挛相关疾病状态病理生理过程的潜在参与者。
为了研究外周动脉闭塞性疾病（PAOD）患者动态运动时内皮素 -1的释放情况，采用放射免疫分析法测定了16例Fontaine IIb期外周动脉闭塞性疾病患者（14例男性，2例女性，平均年龄56.2±8.1岁）和10例健康对照者（8例男性，2例女性，平均年龄58.1±7.2岁）在跑步机测试（坡度5%，速度3 km/hr）过程中的血浆浓度。在静息状态下从前臂静脉采集血样，在出现间歇性跛行疼痛时以及运动后10分钟采集血样。
在应激测试期间，动脉疾病患者的平均血浆内皮素浓度显著增加，从基础值4.4±0.6 pmol/L升至测试结束时的8.9±0.7 pmol/L（p < 0.0001），而对照者的血浆内皮素浓度无显著变化（从2.6±0.4 pmol/L升至2.7±0.5 pmol/L）。此外，动脉疾病患者的血浆内皮素浓度在所有时间均高于对照者（p < 0.0001）。
总之，本研究表明，在外周动脉闭塞性疾病患者中，进行跑步机运动直至出现间歇性跛行疼痛后，血浆内皮素 -1会升高。内皮素 -1升高可能是缺血性急性内皮损伤的标志物，和/或可能通过促进动脉/小动脉血管收缩或血管痉挛，导致这些患者在动态运动期间缺血肢体的血管阻力增加。
