血血管紧张素Ⅱ水平在先天性心脏病伴肺动脉高压介入封堵术前后的变化

Study of angiotensinⅡ level fluctuation in patients with congenital heart diseases pre- and post-interventional therapy

目的:观察先天性心脏病(先心病)介入封堵术前后血浆血管紧张素Ⅱ(AngⅡ)的浓度变化,探讨其在先心病伴肺动脉高压(PH)中的作用及其临床意义。方法:选取70例儿童和70例成人先心病患者,儿童或成人患者中均分为中重度PH组[肺动脉收缩压>50mmHg(1mmHg=0.133kPa)]、轻度PH组(30mmHg≤肺动脉收缩压≤50mmHg)、无PH组(肺动脉收缩压<30mmHg)。用放射免疫法测定所有患者术前,术后24h、1、3、6及12个月血浆AngⅡ浓度。另选取年龄及性别与之相匹配的正常体检儿童30例,成人30例作为对照组。结果:介入封堵术前,无论儿童或成人先心病中重度PH、轻度PH组患者血浆AngⅡ水平均明显高于先心病无PH组患者(P<0.01)。先心病患者介入封堵术后24h,AngⅡ开始逐渐下降,至12个月下降到正常水平。结论:AngⅡ可能参与了先心病伴PH的发生、发展过程。

Objective：To observe the change of Angiotensin Ⅱ （Ang Ⅱ ） in CHD pre- and post- interventional therapy, and explore its role in pulmonary hypertension with CHD. Method：Plasma Ang Ⅱ were assayed at Pre-Interventional Therapy and at 24 hours , 1 month, 3 months, 6 months and 12 months after Interventional Therapy in 70 children with CHD： 20 cases had moderate or severe pulmonary hypertension（group A） and 30 cases had slight pulmonary hypertension（group B） ,the other 20 cases had normal pressure （group C） ; and 30 cases of the control group were enrolled in the study; plasma Ang Ⅱ were assayed at Pre-Interventional Therapy and at 24 hours , 1 month, 3 months, 6 months and 12 months after Interventional Therapy in 70 adults with CHD：20 cases had moderate or severe pulmonary hypertension（group A） and 30 cases had slight pulmonary hypertension（group B ） , the other 2 0 cases had normal pressure （ group C ） ; and 3 0 cases of the control group were enrolled in the study. Result：Plasma Ang Ⅱ concentrations in group A and group B were significantly higher than that of group C （ P 〈0.01）. In the three group, the plasma AngⅡ concentration begin to decrease at 1 month after Interventional Therapy, and at 12 months its concentration near the normal level. And plasma Ang Ⅱ concentration had a positive linear correlation with PH （children group： r = 0. 715, P d0.05; adults group, r = 0. 650, P 〈0. 05）. Conclusion： Ang Ⅱ may have an important role in the pathogenesis of HP.