摘要
目的探讨高原慢性肺心病(HACCP)患者肺血管活性因子变化及其与肺动脉高压(PAH)的关系。方法采用放射免疫分析法检测65例HACCP急性加重期和60例缓解期患者血浆中介素(IMD)、肾上腺髓质素(ADM)、内皮素-1(ET-1)含量,用血气分析仪测定动脉血氧分压(PaO2),用多普勒超声心动仪测定肺动脉血流频谱,计算平均肺动脉压(mPAP),并与40例当地健康人比较。结果 HACCP急性加重期和缓解期患者血浆IMD、ADM、ET-1及mPAP[分别为(156.6±15.2)pg/mL、(71.7±6.3)pg/mL、(90.8±9.5)ng/L、(44.7±6.5)mmHg和(112.3±12.5)pg/mL、(47.8±4.2)pg/mL、(64.9±6.6)ng/L、(34.9±5.2)mmHg]较对照组[分别为(60.6±9.8)pg/mL、(21.8±3.2)pg/mL、(34.8±4.3)ng/L、(21.2±3.4)mmHg]显著升高,PaO2[分别为(36.4±5.3)mmHg、(48.8±4.4)mmHg]较对照组[(68.2±3.5)mmHg]显著降低(均P<0.01)。急性加重期与缓解期比较亦有非常显著性差异(均P<0.01)。急性加重期及缓解期患者mPAP与血浆IMD、ADM、ET-1均呈显著正相关(分别r=0.688、0.719、0.723及0.569、0.591、0.627,均P<0.01),PaO2与IMD、ADM、ET-1均呈显著负相关(分别r=-0.625、-0.698、-0.638及-0.641、-0.536、-0.562,均P<0.01)。结论 IMD、ADM、ET-1共同参与了HACCP患者PAH形成的病理生理过程,其比例失衡可能是导致高原肺心病低氧性PAH发生发展的重要因素。
Objective To assess the changes of pulmonary vasoactive factors and its relation with pulmonary arterial hypertension （PAH） in patients with chronic cor pulmonale at high alti- tude （HACCP） area. Methods The levels of plasma intermedin（IMD） , adrenomedulin（ ADM）, endothelin-1 （ET-1） , partial pressure of oxygen in artery blood （PaO2 ） , and mean pulmonary arte- rial pressure （mPAP）were measured in 65 patients with exacerbation and 60 patients with stable HACCP, the upper mentioned parameters were meated in 40 healthy peoples. Results Levels of plasma IMD,ADM,ET-1 ,and mPAP in patients with exacerbation and stable HACCP [ （156.6 ± 15.2）pg/mL,（71.7 ±6.3）pg/mL,（90.8 ±9.5）ng/L,（44.7 ±6.5）mm Hg and（112.3 ±12.5） pg/mL, （47.8 ± 4.2 ） pg/mL, （ 64.9 ± 6.6 ） ng/L, （ 34.9 ＋ 5.2 ） mm Hg, respectively ] were both markedly higher, and PaO2 [ （ 36.4 ± 5.3 ） mm Hg, （ 48.8 ± 4.4 ） mm Hg, respectively ] was bothmarkedly lower than those in the the normal control subjects [ （60.6 ± 9.8 ）pg/mL, （21.8 ± 3.2） pg/mL, （34.8 ± 4.3 ） ng/L, （21.2± 3.4） mm Hg, （68.2 ± 3.5 ）mm Hg , respectively ] （ all P 〈 0.01 ）, all parameters in patients with exacerbation HACCP were different significantly compared with those in patients with stable HACCP （ all P 〈 0.01 ）. The mPAP was both positively eorreled with IMD,ADM,ET-1 （r =0. 688,0. 719,0. 723 and 0. 569,0. 591,0. 627,respectively ,all P 〈 0.01 ）, and PaO2 was both netatively correlated with IMD, ADM, ET-1 （ r = - 0. 625, - 0. 698, - 0.638 and - 0. 641, - 0. 536, - 0.562, respectively, all P 〈 0.01 ） in patients with exacerbation and stable HACCP. Conclusion IMD, ADM and ET-1 may play important roles in mechanism of PAH in HACCP. Imbalance of these factors have great effeets on the development of hypoxie pulmonary hypertasion in HACCP.
出处
《中华肺部疾病杂志（电子版）》
CAS
2011年第3期38-42,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
肺疾病
慢性阻塞性
肺动脉高压
中介素
内皮素
肾上腺髓质素
高原地区
Chronic obstructive pulmonary disease
Intermedin
Endothelin-1
Adrenomedulin
Pulmonary artery hypertension
obstructive
Highaltitude area
