慢性肺心病早期患者运动试验时内皮依赖性舒缩因子的变化

Changes of plasma endothelium derived relaxing factor and endothelin 1 in patients with chronic cor pulmonale at exercise test

目的实验观察了１０例慢性阻塞性肺疾病肺心病早期患者运动试验时血浆一氧化氮（ＮＯ）和内皮素－１（ＥＴ－１）的变化及其与肺动脉压（ｍＰＡＰ）的关系。方法用心导管，放射免疫与生化检测等技术。结果静息时ｍＰＡＰ＜２．６７ｋＰａ者（Ａ组，５例）血浆ＮＯ含量明显低于ｍＰＡＰ≥２．６７ｋＰａ者（Ｂ组，５例）；运动时血浆ＮＯ含量显著增加，但Ａ组增加的幅度（９９％）较Ｂ组（３４％）显著为高；血浆ＥＴ－１含量无显著改变；ｍＰＡＰ在两组与血浆ＮＯ、ＥＴ－１含量均呈显著正相关。结论慢性阻塞性肺疾病肺心病早期患者已处于显著代偿性释放ＮＯ的状态，但其释放贮备已大大降低。

Objective The authers investigated the levels of plasma EDRF nitric oxide (NO) and ET 1 in 10 cases of cor pulmonale at exercise. Methods Using the technologies of cardiac catheter, radioimmunization and biochemical analysis. Results The level of plasma NO was lower in group A (mean pulmonary artery pressure (mPAP) <2.67kPa) than in group B (mPAP≥2.67kPa) at rest; the content of plasma NO increased more markedly in group A than in group B during exercise; there was no change in the content of ET 1 in both groups; mPAP strongly correlated with plasma NO or ET 1 in both groups. Conclusions The patients with cor pulmonale at early stage may be in a state of compensated release of NO, but its release reserve has been reduced.