经皮二尖瓣球囊扩张术前后血浆内皮素－1水平的对比研究

Plasma endothelin-1 levels before and after PBMV

采用放射免疫分析法（ＲＩＡ）测定了３８例二尖瓣狭窄（ＭＳ）患者经皮球囊二尖瓣扩张术（ＰＢＭＶ）前后血浆内皮素－１（ＥＴ－１）水平，并与二尖瓣面积（ＭＶＡ）、左房内径（ＬＡＤ）及血液动力学参数作相关分析。结果显示：术前血浆ＥＴ－１水平较对照组显著升高（Ｐ＜０．００１），术后显著降低（与术前比Ｐ＜０．００１），但仍高于对照组（Ｐ＜０．００２）。血浆ＥＴ－１水平与平均肺动脉压、平均左房压和ＬＡＤ呈显著正相关（ｒ＝０．７８３，０．５１２和０．３５２，Ｐ＜０．００１，０．００２和０．０５），与其它血液动力学参数无明显相关关系。研究表明，ＥＴ－１在ＭＳ引起的病理生理改变中起重要作用，测定其变化，有可能作为判定病清程度及ＰＢＭＶ疗效的一个指标。

Abstract The levels of plasma endothelin-1(ET-1) in 38 patients with mitral stenosis (MS) before and after percutaneous balloon mitral valvuloplasty(PBMV) were measured by radioimmunoassay (RIA). In addition, other factors possibly affecting the secretion of ET-1 were also studied. The results showed that ET-1 levels in MS group were significantly higher than that in control group(P<0. 001) and decreased significantly affer PBMV (P<0. 001) but still higher than those in control group(P<0. 002). There were significant positive correlations between ET-1 level and mean pulmonary artery pressure (MPAP), mean left atrial pressure(MLAP) and left atrial diameter (LAD) (r=0. 783,0. 512 and 0. 352 respectively). The results suggested that ET-1 may play an important role in the pathophysiological process of rheumatic MS and the plasma ET-1 levels before and after PBMV may be a parameter of evaluating the severity of MS and effect of PBMV.