红景天对高原慢性肺心病患者肺动脉压的影响及其作用机制  

Effects of rhodiola on pulmonary arterial pressure in patients with chronic cor pulmonale in acute exacerbation at high altitude areas and its mechanism

作　　者：冯恩志[1] 郭振援[1] 杨生岳[1] 黄宁侠[1] 张瑛[1] 田忠新[1] 董红梅[1] 

机构地区：[1]解放军第四医院兰州军区呼吸内科中心,西宁810007

出　　处：《中华保健医学杂志》2010年第4期261-263,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨红景天对高原地区慢性肺心病急性加重期患者肺动脉高压(PAH)的影响及其作用机制。方法 60例高原慢性肺心病急性加重期患者随机分为两组,每组30例。红景天治疗组(A组)在常规治疗的基础上,给予口服红景天胶囊,每次2.0g,3/d,共4周。常规治疗组(B组)给予常规治疗。两组在治疗前及治疗4周后分别测血浆内皮素-1(ET-1)、一氧化氮(NO)、动脉血氧分压(PaO2)、平均肺动脉压(mPAP)、右心室流出道(RVOT)、右心室内径(RV),并以40例当地健康人作为对照(C组)。结果治疗后,A组和B组的ET-1、mPAP、RVOT、RV(分别为65.54±11.33ng·L-1、30.45±3.24mmHg、30.22±2.98mm、23.16±2.69mm和82.58±13.30ng·L-1、36.14±4.15mmHg、34.34±3.09mm、26.35±3.04mm)较治疗前(分别为121.62±18.15ng·L-1、48.86±5.72mmHg、39.05±4.65mm、30.14±3.36mm和120.55±19.33ng·L-1、47.56±5.36mmHg、38.71±4.55mm、29.88±3.32mm)显著降低(均P<0.01),NO、PaO2(分别为69.23±10.58μmol·L-1、54.57±5.88mmHg和53.77±8.61μmol·L-1、48.26±4.58mmHg)较治疗前(分别为44.02±9.35μmol·L-1、35.98±5.13mmHg和42.92±8.95μmol·L-1、36.77±4.98mmHg)显著升高(均P<0.01),A组较B组改善更显著(均P<0.01)。ET-1与mPAP、RVOT、RV呈显著正相关(r=0.726、0.735、0.699,均P<0.01),与NO、PaO2呈显著负相关(r=-0.816、-0.782,均P<0.01)。结论红景天可改善高原地区慢性肺心病急性加重期PAH,其机制可能是通过选择性作用于肺血管,抑制ET-1而增加NO的合成与释放,降低肺动脉压和改善右心功能。Objective To study the effects of rhodiola on pulmonary arterial pressure（PAP）in patients with Chronic Cor Pul monale in Acute Exacerbation at High Altitude Areas（HACCP）and Its Mechanism.Methods Sixty patients with acute exacerbation of HAECCP were randomly divided into 2 groups with 30 cases in each,rhodiola therapy group（group A）（combination routine and rhodiola,2.0 g of rhodiola was given orally,three times daily）and routine therapy group（group B）（routine treatment）.Levels of plasmic endothelin-1（ET-1）,nitric oxide（NO）,arterial oxygen partial pressure（PaO2）,mean PAP（mPAP）,outflow tract of right ventricle（RVOT）and internal diameter of right ventricle（RV）were measured before and 4 weeks after treatment.Fouty healthy people in local district were enrolled as normal control group（group C）.Results Levels of plasmic ET-1,NO,PaO2,mPAP,RVOT,RV in group A and group B were 65.54±11.33 ng·L-1,30.45±3.24 mmHg,30.22±2.98 mm,23.16±2.69 mm versus 82.58±13.30 ng·L-1,36.14± 4.15 mm Hg,34.34±3.09 mm,26.35± 3.04 mm,respectively,in both groups all the data were significantly lower than those before treatment 121.62±18.15 ng·L-1,48.86±5.72 mm Hg,39.05±4.65 mm,30.14±3.36 mm and 120.55±19.33 ng·L-1,47.56±5.36 mm Hg,38.71±4.55 mm,29.88±3.32 mm,respectively]（all P〈0.01）,levels of NO,PaO2 69.23 ±10.58 μmol·L-1,54.57 ±5.88 mm Hg and 53.77 ±8.61 μmol·L-1,48.26 ±4.58 mm Hg,respectively were both significantly higher than those before treatment 44.02 ±9.35 μmol·L-1,35.98±5.13 mmHg and 42.92±8.95 μmol·L-1,36.77±4.98 mm Hg,respectively（all P〈0.01）.All parameters in group A was significantly improved compared with those in group B（all P〈0.01）.The levels of plasmic ET-1 was positively correlated with mPAP,RVOT,RV（r =0.726,0.735,0.699,respectively,all P〈0.01）,negatively correlated with NO and PaO2（r=-0.816,-0.782,respectively,all P〈0.01）.Conclusions It is effective using rhodiola in treating patients with pulmonary artery hypert

关 键 词：肺心病 肺动脉高压 红景天 一氧化氮 内皮素 

分 类 号：R563[医药卫生—呼吸系统]