经皮球囊二尖瓣扩张术前后血浆NO、ET及血流动力学的变化  

Study on the Changes of levels of Plasmic NO and Endothelin and Hemodynamics Before and After Percutaneous Balloon Mitral Valvuloplasty

作　　者：芮磊[1] 刘甲兴[1] 李俭春[1] 

机构地区：[1]解放军第180医院心内科,福建泉州362000

出　　处：《江西医学院学报》2005年第3期69-71,共3页Acta Academiae Medicinae Jiangxi

摘　　要：目的观察经皮球囊二尖瓣扩张术(Percutaneousballoonmitralvalvuloplasty,PBMV)前后血浆NO、ET及血流动力学的变化及意义。方法采用化学比色法、放射免疫分析法分别测定23例健康查体人群(对照组)和30例风湿性心脏病二尖瓣狭窄患者(观察组)PBMV术前、术后的NO、ET的血浆浓度;用二维彩色多普勒超声和心导管测定二尖瓣瓣口面积(MVA)、左心房内径(LAD)、平均二尖瓣压力阶差(mMPG)、肺动脉平均压(mPAP)和左房平均压(mLAP)。结果NO浓度术后(74.462±23.913)μmol/L明显低于术前(107.350±33.614)μmol/L(P<0.01),ET浓度术后(100.147±31.904)ng/L明显低于术前(131.632±43.284)ng/L(P<0.01),术前MVA、LAD、mLAP、mMPG、mPAP分别为(1.026±0.201)cm2、(5.168±0.548)cm、(2.765±0.597)kPa、(1.748±0.729)kPa、(5.601±0.728)kPa;术后MAV、LAD、mLAP、mMPG、mPAP分别为(1.725±0.248)cm2、(4.895±0.585)cm、(1.738±0.418)kPa、(0.862±0.415)kPa、(4.155±0.436)kPa,术后血流动力学较术前有明显改善(P<0.05)。血浆NO浓度与mLAP、mPAP呈正相关(r=0.564,P<0.01,r=0.453,P<0.01);血浆ET浓度与mLAP、mPAP呈正相关(r=0.527,P<0.01;r=0.528,P<0.01)。结论NO、ET可作为判断风心二狭病情和PBMV疗效及心功能的良好指标。Objective To observe the changes of the plas mic nitric oxide(NO),endorhelin(ET)and hemodyna mics before and after PBMV in 30 patients with rheumatic mitral stenosis.Methods The levels of plasmic NO and ET in patients after PBMV and before PBMV were studied by chemical colorinetric analysis and radioim munoassay.The MVA,LAD,mMPG,mPAP and mLAP were measured by two-dimensional color Doppler and cardiact catheter.Results The levels of plasmic NO in patients were(107.350±33.614)μmol/L before and (74.462±(23.913))μmol/L afte PBMV.The levels of plasmic ET in patients were(131.632±43.284)ng/L before and((100.147)±31.904)ng/L after PBMV.The MVA,LAD,mLAP,mMPG and mPAP were(1.026±0.201)cm^2,(5.168±0.548)cm,(2.765±0.597)kPa,(1.747±0.729)kPa,(5.601±0.728)kPa res pectively before PBMV and were(1.725±0.248)cm^2,(4.895±0.585)cm,(1.738±0.418)kPa,(0.862±0.415)kPa,(4.155±0.436)kPa res pectively afrer PBMV.The plasmic levels of NO were positivery related with mLAP and mPAP(r=0.564、r=0.453,respectively,P<0.01);The plasmic levels of ET were positively related with mLAP and mPAP(r=0.527、r=0.528,respectively,P<0.01).Conclusion The levels of plasmic NO and ET are related to the degree of heart failure.It may be an indicator of condition and curative effect of PBMV.

关 键 词：经皮球囊二尖瓣扩张术 一氧化氮 内皮素 

分 类 号：R542.51[医药卫生—心血管疾病] R654.2[医药卫生—内科学]