风湿性心脏病病人心包液中内皮素与心脏功能的关系  

Association of endolhelin levels in the pericardial fluid with cardiac function in patients with rheumatic heart disease

作　　者：刘洁琳[1] 王金城[1] 严山[1] 王世奇[1] 李进华[1] 刘雅[1] 陈新军[1] 王佐广[1] 张维君[1] 温绍君[1] 

机构地区：[1]首都医科大学附属北京安贞医院北京市心肺血管疾病研究所高血压研究室,100029

出　　处：《中华胸心血管外科杂志》2009年第5期335-338,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：本课题受北京市科技项目资助（编号：H010910070113）

摘　　要：目的探讨风湿性心脏病病人心包液中内皮素（ET）浓度与心脏功能的关系。方法选取51例风湿性心脏病行心内直视术者，入院24h内行经胸二维多普勒超声心动图检查，术中采集静脉血和心包液各4ml、心包组织100～150mg，利用放射免疫分析方法测定上述样本中内皮素的含量。结果心包液中肼显著高于其在血浆中的水平[（128．79±43．58）pg/ml对（102．71±39．81）pg/ml，P=0．003）。心包组织匀浆中也有较高浓度的ET。左室射血分数（LVEF）小于0．50的病人心包液和心包组织中ET含量显著高于LVEF大于0．50，并与左室射血分数呈负相关，与左室收缩末内径和左室舒张末内径呈正相关。结论风湿性心脏病病人心包液和心包组织中存在高浓度的内皮素，并可能参与风湿性心脏病者心脏功能的调节。Objective Endothelin levels in the plasma were shown to increase as the cardiac function became deteriorated. We investigate the association of endothelin levels in the pericardial fluid with cardiac function in patients with rheumatic heart disease （RHD）. Methods The study involved 51 patients, 24 were male and 27 were female, who underwent elective heart valvuloplasty or valve replacement for rheumatic heart diseases. Doppler echocardiography was performed within 24 hours after admission for all patients by 2 experienced attending doctors. Endothelin concentrations were measured with radioimmunoassay in samples of venous blood, pericardial fluid and pericardial tissue obtained during open heart surgery. Blood samples were collected from the cannulated brachial artery at the same time. Results Endothelin levels in the pericardial fluid were higher sigrrificandy than those in the plasma [ （128.79 ± 43.58） pg/ml vs （102.71 ± 39.81 ） pg/ml, P = 0. 003）No association was observed between endothelin levels in pericardial fluid and that in the plasma. Tissue homogenate of the pericardium contained endothelin at high concentration as well. As compared with patients whose left ventricular ejection fraction （LVEF） were less than 0.50, those with LVEF ≥ 0.50 had signifieandy lower endothelin concentrations in their pericardial fluid and pericarditml. No significant difference in the plasma concentrations of endothehn was found between two groups. Endothelin levels in the perieardial fluid correlated negatively with left ventricular ejection fraction, and positively with left ventricular end-systolic dimension （LVESD） and left ventricular end-diastolic dirnension（LVEDD）. The plasma concentrations of endothelin did not correlated with the parameters. Conclusion High levels of entothelin existed in the pericardial fluid and the pericardium of patients with RHD. The association of endothelin concentrations in the perieardial fluid with cardiac function indicates that endothelin in the pericardial

关 键 词：风湿性心脏病 心包 内皮缩血管肽 心室功能 

分 类 号：R686[医药卫生—骨科学]