中华肺部疾病杂志（电子版）
中華肺部疾病雜誌（電子版）
중화폐부질병잡지（전자판）
CHINESE JOURNAL OF LUNG DISEASE（ELECTRONIC EDITION）
2011年
3期
211-215
,共5页
杨生岳%郭振援%冯恩志%闫自强%王绍林%祁玉曙%贺巍%田忠新%殷和%张瑛
楊生嶽%郭振援%馮恩誌%閆自彊%王紹林%祁玉曙%賀巍%田忠新%慇和%張瑛
양생악%곽진원%풍은지%염자강%왕소림%기옥서%하외%전충신%은화%장영
肺疾病,慢性阻塞性%肺动脉高压%中介素%内皮素%肾上腺髓质素%高原地区
肺疾病,慢性阻塞性%肺動脈高壓%中介素%內皮素%腎上腺髓質素%高原地區
폐질병,만성조새성%폐동맥고압%중개소%내피소%신상선수질소%고원지구
Chronic obstructive pulmonary disease%Intermedin%Endothelin-1%Adrenomedulin%Pulmonary artery hypertension%obstructive%High altitude area
目的 探讨高原慢性肺心病(HACCP)患者肺血管活性因子变化及其与肺动脉高压(PAH)的关系.方法 采用放射免疫分析法检测65例HACCP急性加重期和60例缓解期患者血浆中介素(IMD)、肾上腺髓质素(ADM)、内皮素-1(ET-1)含量,用血气分析仪测定动脉血氧分压(PaO2),用多普勒超声心动仪测定肺动脉血流频谱,计算平均肺动脉压(mPAP),并与40例当地健康人比较.结果 HACCP急性加重期和缓解期患者血浆IMD、ADM、ET-1及mPAP[分别为(156.6±15.2)pg/mL、(71.7±6.3)pg/mL、(90.8±9.5)ng/L、(44.7±6.5)mm Hg和(112.3±12.5)pg/mL、(47.8±4.2)pg/mL、(64.9±6.6)ng/L、(34.9±5.2)mm Hg]较对照组[分别为(60.6±9.8)pg/mL、(21.8±3.2)pg/mL、(34.8±4.3)ng/L、(21.2±3.4)mm Hg]显著升高,PaO2[分别为(36.4±5.3)mm Hg、(48.8±4.4)mm Hg]较对照组[(68.2±3.5)mm Hg]显著降低(均P<0.01).急性加重期与缓解期比较亦有非常显著性差异(均P<0.01).急性加重期及缓解期患者mPAP与血浆IMD、ADM、ET-1均呈显著正相关(分别r＝0.688、0.719、0.723及0.569、0.591、0.627,均P＜0.01),PaO2与IMD、ADM、ET-1均呈显著负相关(分别r＝-0.625、-0.698、-0.638及-0.641、-0.536、-0.562,均P＜0.01).结论 IMD、ADM、ET-1共同参与了HACCP患者PAH形成的病理生理过程,其比例失衡可能是导致高原肺心病低氧性PAH发生发展的重要因素.
目的 探討高原慢性肺心病(HACCP)患者肺血管活性因子變化及其與肺動脈高壓(PAH)的關繫.方法 採用放射免疫分析法檢測65例HACCP急性加重期和60例緩解期患者血漿中介素(IMD)、腎上腺髓質素(ADM)、內皮素-1(ET-1)含量,用血氣分析儀測定動脈血氧分壓(PaO2),用多普勒超聲心動儀測定肺動脈血流頻譜,計算平均肺動脈壓(mPAP),併與40例噹地健康人比較.結果 HACCP急性加重期和緩解期患者血漿IMD、ADM、ET-1及mPAP[分彆為(156.6±15.2)pg/mL、(71.7±6.3)pg/mL、(90.8±9.5)ng/L、(44.7±6.5)mm Hg和(112.3±12.5)pg/mL、(47.8±4.2)pg/mL、(64.9±6.6)ng/L、(34.9±5.2)mm Hg]較對照組[分彆為(60.6±9.8)pg/mL、(21.8±3.2)pg/mL、(34.8±4.3)ng/L、(21.2±3.4)mm Hg]顯著升高,PaO2[分彆為(36.4±5.3)mm Hg、(48.8±4.4)mm Hg]較對照組[(68.2±3.5)mm Hg]顯著降低(均P<0.01).急性加重期與緩解期比較亦有非常顯著性差異(均P<0.01).急性加重期及緩解期患者mPAP與血漿IMD、ADM、ET-1均呈顯著正相關(分彆r＝0.688、0.719、0.723及0.569、0.591、0.627,均P＜0.01),PaO2與IMD、ADM、ET-1均呈顯著負相關(分彆r＝-0.625、-0.698、-0.638及-0.641、-0.536、-0.562,均P＜0.01).結論 IMD、ADM、ET-1共同參與瞭HACCP患者PAH形成的病理生理過程,其比例失衡可能是導緻高原肺心病低氧性PAH髮生髮展的重要因素.
목적 탐토고원만성폐심병(HACCP)환자폐혈관활성인자변화급기여폐동맥고압(PAH)적관계.방법 채용방사면역분석법검측65례HACCP급성가중기화60례완해기환자혈장중개소(IMD)、신상선수질소(ADM)、내피소-1(ET-1)함량,용혈기분석의측정동맥혈양분압(PaO2),용다보륵초성심동의측정폐동맥혈류빈보,계산평균폐동맥압(mPAP),병여40례당지건강인비교.결과 HACCP급성가중기화완해기환자혈장IMD、ADM、ET-1급mPAP[분별위(156.6±15.2)pg/mL、(71.7±6.3)pg/mL、(90.8±9.5)ng/L、(44.7±6.5)mm Hg화(112.3±12.5)pg/mL、(47.8±4.2)pg/mL、(64.9±6.6)ng/L、(34.9±5.2)mm Hg]교대조조[분별위(60.6±9.8)pg/mL、(21.8±3.2)pg/mL、(34.8±4.3)ng/L、(21.2±3.4)mm Hg]현저승고,PaO2[분별위(36.4±5.3)mm Hg、(48.8±4.4)mm Hg]교대조조[(68.2±3.5)mm Hg]현저강저(균P<0.01).급성가중기여완해기비교역유비상현저성차이(균P<0.01).급성가중기급완해기환자mPAP여혈장IMD、ADM、ET-1균정현저정상관(분별r＝0.688、0.719、0.723급0.569、0.591、0.627,균P＜0.01),PaO2여IMD、ADM、ET-1균정현저부상관(분별r＝-0.625、-0.698、-0.638급-0.641、-0.536、-0.562,균P＜0.01).결론 IMD、ADM、ET-1공동삼여료HACCP환자PAH형성적병리생리과정,기비례실형가능시도치고원폐심병저양성PAH발생발전적중요인소.
Objective To assess the changes of pulmonary vasoactive factors and its relation with pulmonary arterial hypertension (PAH) in patients with chronic cor pulmonale at high altitude (HACCP) area. Methods The levels of plasma intermedin(IMD), adrenomedulin(ADM), endothelin-1 (ET-1), partial pressure of oxygen in artery blood(PaO2) ,and mean pulmonary arterial pressure(mPAP)were measured in 65 patients with exacerbation and 60 patients with stable HACCP,the upper mentioned parameters were meated in 40 healthy peoples. Results Levels of plasma IMD,ADM,ET-1,and mPAP in patients with exacerbation and stable HACCP [(156.6±15.2)pg/mL,(71.7±6.3)pg/mL,(90.8±9.5)ng/L,(44.7±6.5)mm Hg and(112.3±12.5)pg/mL,(47.8±4.2)pg/mL,(64.9±6.6)ng/L,(34.9±5.2)mm Hg,respectively] were both markedly higher,and PaO2[(36.4±5.3)mm Hg,(48.8±4.4)mm Hg, respectively] was both markedly lower than those in the the normal control subjects[(60.6±9.8)pg/mL,(21.8±3.2)pg/mL,(34.8±4.3)ng/L,(21.2±3.4)mm Hg, (68.2±3.5)mm Hg , respectively] (all P<0.01),all parameters in patients with exacerbation HACCP were different significantly compared with those in patients with stable HACCP (all P<0.01). The mPAP was both positively correled with IMD、ADM、ET-1 (r＝0.688,0.719,0.723 and 0.569,0.591,0.627,respectively ,all P＜0.01), and PaO2 was both netatively correlated with IMD,ADM,ET-1(r＝-0.625,-0.698,-0.638 and -0.641,-0.536,-0.562,respectively,all P＜0.01)in patients with exacerbation and stable HACCP.Conclusion IMD,ADM and ET-1 may play important roles in mechanism of PAH in HACCP. Imbalance of these factors have great effects on the development of hypoxic pulmonary hypertasion in HACCP.
