高原慢性肺心病急性加重期血清碱性成纤维细胞生长因子水平与肺动脉压的关系及其干预的研究  

The Relationship between Change of Serum Basic Fibroblast Growth Factor Level and Pulmonary Arterial Pressure and Its Intervention in Patients with Chronic Cor Pulmonale at High Altitude Areas

作　　者：杨生岳[1] 沈君礼[1] 郭振援[1] 冯恩志[1] 王绍林[1] 董红梅[1] 张瑛[1] 田忠新[1] 刘丽君[1] 

机构地区：[1]解放军第四医院呼吸内科,青海西宁810007

出　　处：《中国临床医学》2008年第1期47-49,共3页Chinese Journal of Clinical Medicine

基　　金：青海省重点科技攻关项目(2006-N-143)

摘　　要：目的：探讨碱性成纤维细胞生长因子（bFGF）在低氧性肺动脉高压发病中的作用及其干预治疗。方法：60例高原慢性肺心病急性加重期患者随机分为3组，每组20例。3组抗感染、祛痰、平喘治疗相同。氧疗组：给予持续吸氧，氧流量1.5～3.0L·minˉ^1，使动脉血氧分压（Pa02）保持在55mmHg以上；红景天组：口服红景天胶囊每次2.0g，每天3次·dˉ^1。常规治疗组：给予常规治疗。在治疗前、治疗3周后，采用酶联免疫吸附法检测血清bFGF水平，用超声心动仪测平均肺动脉压（mPAP）和用血气分析仪测PaO2。并以30例慢性阻塞性肺疾病（COPD）和30例当地健康人作对照。结果：肺心痛组血清bFGF（87.25±12.10）Pg·mIˉ^1、mPAP（45.66±5.61）mmHg，显著高于cOPD组[分别为（55.02±9.08）Pg·mLˉ^1、（22.98±2.41）mmHg，均P＜0.01），COPD组显著高于健康人对照组[分别为（49.83±8.78）Pg·mlˉ^1、（20.34±2.23）mmHg，均P＜O.01）；肺心痛组Pa02（38.68±4.46）mmHg显著低于COPD组（58.05±6.18）mmHg，COPD组显著低于健康人对照组（66.57±5.48mmHg，均P＜O.01）。肺心痛组和COPD组血清bFGF水平与mPAP均呈显著正相关（r=0.788、0.674，均P＜0.01），与Pa02水平呈显著负相关（r=-0.735、-0.587，均P＜0.01）。治疗后，肺心痛3组患者血清bFGF、mPAP较治疗前显著降低、Pa02显著升高（均P＜0.01），但氧疗组改善较红景天组显著、红景天组较常规治疗组显著，（均P＜0.05）。结论：高原慢性肺心病患者血清bFGF水平明显升高，可能与其慢性低氧性肺动脉高压的形成有一定关系，氧疗和红景对其有显著治疗作用。Objective：To assess the relationship between change of serum basic fibroblast growth factor（ bFGF） level and pul-monary arterial pressure and its intervention in patients with chronic cor pulmonale at high altitude areas（HACCP）. Methods： Sixty patients with acute exacerbation of HACCP were randomly divided into 3 groups with 20 cases in each： a oxygen therapy group （combination routine and oxygen therapy）, a rhodiola group（combination routine and rhodiola,2.0g of rhodiola was given orally,three times daily）and a routine therapy group （routine treatmlent）. The levels of bFGF in serum were measured by ELISA, mean pulmonary arterial pressure（mPAP） was measured by echocardiography,and the PaO2 was measured by blood gas analyzer before and 3 weeks after treatment. Another,the upper mentioned parameters were measured in 30 patients with chronic obstructive pulmonary disease （COPD） and 30 healthy peoples. Results： The level of serum bFGF （87.54±12.15）pg·mLˉ^1 and mPAP（45.86±5.63）mmHg in the patients with HACCP were significantly higher than those in the patients with COPD[（55.72 ±9.08）pg ·mLˉ^1 , （22.95±2.56）mmHg,respectively,all P〈0.01 ）, the patients with COPD were both significantly higher than those the healthy peoples[（49.83±8.78）pg·mLˉ^1, （20.34±2.23） mmHg,respectively,all P〈0.01）, The PAO2（38.79±4.56）mmHg in the patients with HACCP was significantly lower than that in patients with COPD and healthy peoples[（58.22±6.18）mmHg and 66.57±5.48mmHg, respectively, all P〈0.01）. The levels of serum bFGF In the patients with HACCP and the patients with COPD was positive correlated with mPAP（r = 0.788,0.674,all P〈0.01）, netatively correlated with PaO2 （r =-0.735, -0.587, all P〈0.01）. The after therapy, serum bFGF, mPAP and PaO2 in threegroups of HACCP were all markedly improved compared with those before（all P〈O.01 ）, Those parameters in oxygen therapy group were different markedly compared with those in rhodiola

关 键 词：碱性成纤维细胞生长因子 高血压 肺心病 干预 高原 

分 类 号：R541.5[医药卫生—心血管疾病]