CAJ | 학술논문

目的探讨高原地区房间隔缺损(ASD)患者血浆脑钠肽(BNP)及内皮素(ET-1)浓度的变化以及与肺动脉压力间的关系.方法 105例患者确诊为单纯房间隔缺损(ASD),分为ASD并肺动脉高压组(ASD-PH)和ASD无肺动脉高压组(ASD-nPH),ASD-PH组又分为ASD并轻度肺动脉高压和ASD并中重度肺动脉高压组.所有患者按居住地海拔分2000～2 500m组、2 501～3 500m组及＞3500m组.放射免疫法测定血浆BNP浓度,ELISA法测定ET-1.结果 ASD-PH组患者血清BNP、ET-1的水平明显高于ASD-nPH组,分别为(152.34±40.61) pg/ml对(126.70±32.27) pg/ml和(137.69±37.17)pg/ml对(92.92±32.3) pg/ml.不同程度肺高压患者的血浆BNP及ET-1水平存在显著差异(F=6.782,P＜0.05;F=8.475,P＜0.05).不同海拔ASD患者血浆BNP及ET-1亦存在显著差异(F=6.846,P＜0.05;F=9.327,P＜0.05).ASD患者血浆BNP与平均肺动脉压(mPAP)及缺损大小正相关(分别为r=0.326,P＜0.05和r=0.301,P＜0.05),与患者居住海拔呈正相关(r=0.252,P＜0.05).结论 ASD-PH组患者血清BNP、ET-1的水平明显高于ASD-nPH组,随着肺动脉高压程度的增加及海拔的上升二者均升高,ET、BNP共同参与了肺动脉高压的发生发展,低氧环境促进了ET、BNP的分泌.
목적 탐토고원지구방간격결손(ASD)환자혈장뇌납태(BNP)급내피소(ET-1)농도적변화이급여폐동맥압력간적관계.방법 105례환자학진위단순방간격결손(ASD),분위ASD병폐동맥고압조(ASD-PH)화ASD무폐동맥고압조(ASD-nPH),ASD-PH조우분위ASD병경도폐동맥고압화ASD병중중도폐동맥고압조.소유환자안거주지해발분2000～2 500m조、2 501～3 500m조급＞3500m조.방사면역법측정혈장BNP농도,ELISA법측정ET-1.결과 ASD-PH조환자혈청BNP、ET-1적수평명현고우ASD-nPH조,분별위(152.34±40.61) pg/ml대(126.70±32.27) pg/ml화(137.69±37.17)pg/ml대(92.92±32.3) pg/ml.불동정도폐고압환자적혈장BNP급ET-1수평존재현저차이(F=6.782,P＜0.05;F=8.475,P＜0.05).불동해발ASD환자혈장BNP급ET-1역존재현저차이(F=6.846,P＜0.05;F=9.327,P＜0.05).ASD환자혈장BNP여평균폐동맥압(mPAP)급결손대소정상관(분별위r=0.326,P＜0.05화r=0.301,P＜0.05),여환자거주해발정정상관(r=0.252,P＜0.05).결론 ASD-PH조환자혈청BNP、ET-1적수평명현고우ASD-nPH조,수착폐동맥고압정도적증가급해발적상승이자균승고,ET、BNP공동삼여료폐동맥고압적발생발전,저양배경촉진료ET、BNP적분비.
Objective To explore the change of Brain natriuretic peptide(BNP) and endothelin-1 (ET-1) levels in artial septal defect(ASD) patients and the relationship among BNP,ET-1 and pulmonary pressure.Methods 105 final diagnosed ASD patients were divide into non-pulmonary hypertension group (nPH group) and pulmonary hypertension group(PH group),and the PH group were divided into two subgroup:slight PH group,moderate and sever PH group.According to the altitude of habitation,105 ASD patients also were divided into 3 groups:＜ 2 500 m group,2 501-3 500 m group and ＞ 3 500 m group.Plasma BNP were measured by radioimmunity method and ET-1 were measured by ELISA.The data analysis used single factor analysis and Fisher least singnificant difference t test.Results Both the plasma BNP levels (152.34 ± 40.61) pg/ml and ET-1 level (137.69 ± 37.17) pg/ml of the ASD-PH group were significantly higher than those [BNP (126.70 ± 32.27) pg/ml,ET-1 (92.92 ± 32.3) pg/ml] of ASD-nPH group.There were strong difference in plasma BNP levels and ET-1 levels among different degree PH groups(F =6.782,P ＜ 0.05 ; F =8.475,P ＜ 0.05).Statistical difference were also shown in BNP(F =6.846,P ＜ 0.05) and ET-1 (F =9.327,P ＜ 0.05) levels by compared difference altitude groups.The BNP levels are positively correlated with mean pulmonary artery pressure (r =0.326,P ＜ 0.05),size of defect (r=0.301,P＜0.05) and the altitude of habitation (r =0.252,P＜0.05).Conclusion Plasma BNPand ET-1 levelsof ASD-PH group significantly higher than those of ASD-nPH group.By the increasing of the altitude and PH degree,the plasma BNP and ET-1 levels are increasing,which suggest that BNP and ET-1 play an important role on the proceeding and development of the PH and hypoxia promoted secretion of BNP and ET-1.