肺心病患者血浆内皮素一氧化氮降钙素基因相关肽的研究  

Relationship between plasma endothelin, nitric oxide, calcitonin gene related peptide levels and pulmonary hemodynamics in patients with chronic cor pulmonale

作　　者：白冲[1] 韩一平[1] 刘忠令[1] 王昌惠[1] 李平升[1] 

机构地区：[1]第二军医大学附属长海医院呼吸科

出　　处：《中华结核和呼吸杂志》1998年第7期407-410,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的研究缺氧性肺动脉高压产生的机理。方法经右心导管监测５５例慢性阻塞性肺疾病（ＣＯＰＤ）及慢性肺心病患者５５例，依平均肺动脉压（ｍＰＡＰ）≥２６７ｋＰａ分为Ａ组（２８例），＜２６７ｋＰａ分为Ｂ组（２７例）及２２名健康者（对照组）观察血流动力学变化，并测定其肺动脉血浆内皮素（ＥＴ１）、一氧化氮（ＮＯ）和降钙素基因相关肽（ＣＧＲＰ）水平，以探讨ＥＴ１、ＮＯ、ＣＧＲＰ与肺动脉高压的关系。结果Ａ组患者血浆ＥＴ１水平（７５±５ｎｇ／Ｌ）与Ｂ组患者（５３±５ｎｇ／Ｌ）和对照组（５１±６ｎｇ／Ｌ）比较，差异有显著性（Ｐ＜０．０１），而Ｂ组与对照组间比较，差异无显著性（Ｐ＞０．０５）。Ａ组ＮＯ水平（１５±５μｍｏｌ／Ｌ）与Ｂ组（４３±９μｍｏｌ／Ｌ）和对照组（２２±５μｍｏｌ／Ｌ）比较，差异有显著性（Ｐ＜０．０１），Ａ组与对照组间比较差异有显著性（Ｐ＜０．０５）。Ａ、Ｂ两组ＣＧＲＰ水平分别为２１±５ｎｇ／Ｌ、２５±８ｎｇ／Ｌ，两组比较差异无显著性（Ｐ＞０．０５），对照组为５３±９ｎｇ／Ｌ，对照组与Ａ、Ｂ两组间比较差异有显著性（Ｐ＜０．０１）。并且ＥＴ１水平与肺动脉压呈正相关，动脉血氧分压（ＰａＯ２）呈负相关，而?Objective To explore the relationship between plasma endothlin 1 (ET 1), nitric oxide(NO),calcitonin gene related peptide (CGRP) levels and hypoxic pulmonary hypertension. Method Cardiac catheterization was performed in 55 cases of chronic cor pulmonale to monitor the changes of their hemodynamic indices and to determine the levels of pulmonary arterial plasma ET 1,NO and CGRP. Result The plasma ET 1 level of patients with pulmonary hypertension (Group A) was significantly higher than that of patients without pulmonary hypertension (Group B) and controls. The plasma NO level of group A was significantly lower than that of Group B and controls. The plasma CGRP level of ET 1 had a significantly negative correlation with PaO 2 and positive correlation with pulmonary arterial pressure. The levels of NO and CGRP had significantly positive correlation with PaO 2 and negative correlation with pulmonary arterial pressure. After 60 min oxygenation with 30% oxygen inhalation, the level of ET 1 decreased remarkably, but the levels of NO and CGRP went up notably. Conclusion These results demonstrate that hypoxia affects plasma ET 1, NO,CGRP levels in patients with chronic cor pulmonale.ET 1,NO,CGRP play synergistic roles in regulation of pulmonary arterial pressure.

关 键 词：肺心病 血浆 内皮素 一氧化氮 CGRP 

分 类 号：R541.5[医药卫生—心血管疾病]