高原低氧性肺动脉高压与肺血管内皮功能的相关性研究  

Investigate the relationship between the hypoxia pulmonary artery hypertension and pulmonary vascular endothelial function at high altitude

作　　者：冯恩志[1] 黄宁侠[1] 杨生岳[1] 殷和[1] 田忠新[1] 张瑛[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：《中华肺部疾病杂志（电子版）》2016年第3期248-251,共4页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家科技支撑计划资助项目(2009BA185B003);青海省应用基础研究计划项目资助(2011-Z-710)

摘　　要：目的探讨高原低氧性肺动脉高压（HPH）与肺血管内皮功能的关系。方法选择由平原进驻高原的健康男性官兵80例,年龄18-25岁。进入高原前和进入高原后2 d、30 d、60 d、90 d,分别测定平均肺动脉压（m PAP）、血清低氧诱导促有丝分裂因子（HIMF）、低氧诱导因子-1α（HIF-1α）、血管内皮生长因子（VEGF）、血浆内皮素-1（ET-1）和一氧化氮（NO）含量。结果入高原后2 d,m PAP、血清HIMF、HIF-1α、VEGF、血浆ET-1水平明显高于入高原前,NO含量水平明显低于入高原前,（均P〈0.01）;但入高原后2 d的m PAP、血清HIMF、HIF-1α、VEGF、血浆ET-1水平明显低于入高原后30 d,60 d和90 d,NO水平则明显高于入高原后30、60、90 d（均P〈0.01）;入高原后各指标30 d与60 d和60 d与90 d比较无统计学意义（均P〉0.05）。入高原后2 d,m PAP与HIMF、HIF-1α、VEGF、ET-1呈显著正相关（r=0.568、0.664、0.616、0.598）,与NO呈显著负相关（r=-0.608）,（均P〈0.01）。结论 HIMF、HIF-1α、VEGF、ET-1和NO可能共同参与了HPH的发生发展,高原HPH的发生与肺血管内皮功能受损有密切关系。Objective To assess the relationship between the hypoxia pulmonary artery hypertension（ HPH） and Pulmonary vascular endothelial function at high altitude. Methods Eighty healthy officers and sildiers leaving low altitude area to high altitude area were rolled for study,all of them were male,aged 18-25 years. Levels of mean pulmonary arterial pressure（ m PAP）,hypoxia-induced mitogenic factor（ HIMF）,hypoxia-inducible factor-1α（ HIF-1α）,vascular endothelial growth factor（ VEGF）,endothelin-1（ ET-1） and nitricoxide（ NO） were measured respectively before entering plateau and on 2 days,30 days,60 days,and190 days after entering plateau. Results At 2 days after entering plateau,level of m PAP,serum HIMF,HIF-1α,VEGF,plasma ET-1 were significantly higher,and plasma NO was significantly lower than those of before entering plateau. At 2 days after entering plateau,level of m PAP,serum HIMF,HIF-1α,VEGF,plasma ET-1 were significantly lower,and plasma NO was significantly higher than those of 30 days,60 days and 90 days after entering plateau（ all P0.01）,there were no significantly differences between which 30 days and 60 days,60 days and 90 days（ all P〉0. 05）. At 2 days after entering plateau,m PAP was positively correlated with HIMF,HIF-1α,VEGF and ET-1（ r = 0.568,0.664,0616,0.598,respectively）,and was positively correlated with NO（ r =-0.608）（ all P0.01）. Conclusion HIMF,HIF-1α,VEGF,ET-1 and NO may participated in the pathogenesis of HPH together,the occurrence of HPH has closely correlated with injury of pulmonary vascular endothelial function at high altitude.

关 键 词：低氧性肺动脉高压 低氧诱导促有丝分裂因子 低氧诱导因子 血管内皮生长因子 内皮素 一氧化氮 高原地区 

分 类 号：R563[医药卫生—呼吸系统]