老年慢性阻塞性肺病稳定期血浆ET-1、NO水平与肺动脉高压的相关性  

Correlation between the levels of plasma ET-1,NO and the pulmonary artery systolic pressure in elderly patients in the stable period of COPD

作　　者：章琳[1] 杨渭临[1] 郑华东[1] 李秀丽[1] 

机构地区：[1]西安交通大学医学院第二附属医院老年病科,西安710004

出　　处：《山西医科大学学报》2011年第7期572-574,共3页Journal of Shanxi Medical University

基　　金：陕西省科技厅社发攻关项目(2011K14-10-01)

摘　　要：目的探讨老年慢性阻塞性肺病(COPD)稳定期患者血浆内皮素-1(ET-1)、一氧化氮(NO)水平与肺动脉收缩压之间的关系。方法检测65例老年COPD稳定期患者及30例正常对照人群的血浆ET-1、NO水平,同期应用超声心动图测定所有研究对象的肺动脉收缩压,按是否存在肺动脉高压再将65例患者分为肺动脉高压组和无肺动脉高压组。比较三组研究对象的血浆ET-1、NO水平,并将血浆ET-1、NO水平与肺动脉收缩压进行相关分析。结果 65例老年稳定期COPD患者经检测有20例存在肺动脉高压。正常对照组中未发现肺动脉高压。肺动脉高压组和无肺动脉高压组的血浆ET-1水平较正常对照组明显升高(P<0.05),血浆NO水平较正常对照组明显降低(P<0.05);肺动脉高压组ET-1水平明显高于无肺动脉高压组(P<0.05),血浆NO水平明显低于无肺动脉高压组(P<0.05);肺动脉高压组肺动脉收缩压与血浆ET-1水平呈显著正相关(r=0.379,P<0.05),而与血浆NO水平无显著相关性(P>0.05)。结论老年COPD患者存在肺血管内皮细胞功能不良,内源性NO合成和释放减少,作为反映内皮细胞功能状态的指标,ET-1可在一定程度上反映肺动脉收缩压水平。Objective To investigate the relationship between the levels of plasma endothelin-1（ET-1） and nitric oxide（NO） and the pulmonary artery systolic pressure in elderly patients in the stable period of chronic obstructive pulmonary disease（COPD）. Methods Sixty-five elderly patients in the stable period of COPD were collected and divided into pulmonary hypertension group and non-pulmonary hypertension group.Thirty normal subjects were chosen as the controls.The levels of plasma ET-1 and NO were detected in 65 elderly patients in the stable period of COPD and 30 normal controls and compared between 3 groups.At the same time,echocardiography was applied to measure the pulmonary artery systolic pressure.The relationship between the levels of plasma ET-1 and NO and the pulmonary artery systolic pressure was analyzed. Results Of 65 elderly patients in the stable period of COPD,20 had pulmonary hypertension.No pulmonary hypertension was found in control group.Compared with control group,the levels of plasma ET-1 in both pulmonary hypertension group and non-pulmonary hypertension group increased significantly（P0.05）,while the levels of plasma NO decreased（P0.05）.The level of ET-1 in pulmonary hypertension group was statistically higher than in non-pulmonary hypertension group（P0.05）,while the level of plasma NO was lower than in non-pulmonary hypertension group（P0.05）.The pulmonary artery systolic pressure in pulmonary hypertension group was significantly and positively correlated with the level of plasma ET-1（r=0.384,P0.05）,but not with the plasma NO level（P0.05）. Conclusion Elderly COPD patients have the dysfunction of pulmonary vascular endothelial cells and reduce of the synthesis and release of endogenous nitric oxide.ET-1 can reflect the level of pulmonary artery systolic pressure in some extent.

关 键 词：COPD 肺动脉高压 内皮素-1 一氧化氮 

分 类 号：R563[医药卫生—呼吸系统]