血浆生物活性分子内皮素1浓度的检测可作为评价介入封堵先天性心脏病房间隔缺损患者疗效的指标

Plasma level of ET-1 may be used as a marker for evaluating the effect of transcatheter closure of ASD

目的:探讨介入封堵房间隔缺损(ASD)前后患者血浆内皮素1(ET-1)浓度的变化及其临床意义。方法:检测40例成功接受介入封堵治疗的ASD患者的术前、术后30min和术后3天血浆ET-1浓度。结果:无论ASD患者的肺动脉压是否升高,其血浆ET-1的浓度均明显高于正常对照组;术前ASD患者血浆ET-1浓度与PASP、Qp/Qs和ASD最大伸展径呈正相关,r分别为0.868、0.746、0.670(P均<0.01);ASD患者术后30min和术后3天的血浆ET-1浓度较术前明显下降,术后3天的血浆ET-1浓度较术后30min进一步下降。结论:介入封堵ASD后,患者的肺血管内皮功能得到改善,血浆ET-1浓度的检测可以作为评价介入封堵ASD疗效的指标。

Objective：To study the alteration and clinical significance of plasma endothelin-1 （ET-1） after transcatheter closure of atrial septal defect （ASD）. Methods：Radioimmumoassay was used to measure plasma concentration of ET-1 in 40 ASD patients before,30 minutes after and three days after transcatheter closure of ASD. Results：The plasma level of ET-1 in ASD patients was remarkably higher than that of the control,no matter the ASD patients＇ pulmonary arterial pressure was increased or not. In ASD patients,the plasma concentration of ET-1 correlated with the pulmonary arterial pressure,pulmonary to systemic flow ratio （Qp/Qs） and the size of ASD（r = 0.868, r = 0.746 and r = 0.670,respectively（P 〈 0.01 ）. The plasma level of ET-1 in ASD patients after ASD closure decreased significantly compared with the level before ASD closure. And the plasma concentration of ET-1 in ASD patients three days after ASD closure was lower than that at 30 minutes after ASD closure. Conclusion：The endothelium function in patients with ASD can be improved after transcatheter closure of ASD. The plasma level of ET-1 may be used as a marker for evaluating the effect of transcatheter closure of ASD.