尾加压素Ⅱ、一氧化氮与慢性肺心病肺动脉高压的相关性研究

Correlation of urotensin Ⅱ and nitric oxide with pulmonary hypertension of chronic cardiopulmonary disease

目的：研究血浆尾加压素Ⅱ（UⅡ）、一氧化氮（NO）水平与慢性肺心病患者肺动脉高压（PH）的相关性。方法：用超声心动图测量50例慢性肺心病患者的肺动脉收缩压（PASP），根据PASP大小分为对照组（〈30mmHg）、轻度PH组（30～49mmHg）、中度PH组（50～69mmHg）、重度PH组（≥70mmHg）。用放射免疫法测定血浆UⅡ水平，化学比色法测定血浆NO水平。结果：对照组、轻度PH组、申度PH组、重度PH组UⅡ水平分别为（1．82±0．83）pmol／L、（2．86士0．95）pmol／L、（3．38士1．04）pmol／L、（4．06±0．81）pmol／L。对照组与各PH组UⅡ水平有显著性差异（P〈0．05，P〈0．01），各PH组问也有差异性（P〈0．05）。血浆UⅡ水平与肺动脉压力呈正相关（r=0．648，P〈0．05）。对照组、轻度PH组、中度PH组、重度PH组NO水平分别为（50．01±9．79）umol／L、（74．92±49．83）umol／L、（75．00±26．29）umol／L、（72．32±26．74）umol／L。对照组与各PH组NO水平有显著性差异（P〈0．01），各PH组同无差异。血浆NO水平与肺动脉压力无相关性。结论：UI在PH形成和血管重建中起重要作用．NO增高在PH形成中起保护作用，血浆UⅡ水平可作为判断PH严重程度的指标之一。

Objective：To investigate the correlation of plasma urotensin Ⅱ and nitric oxide level with pulmonary hypertension（PH） in patients with chronic cardiopulmonary disease. Methods：The pulmonary artery systolic pressure （PASP） in 50 patients with chronic cardiopulmonary disease was measured by echocardiography. The patients were divided into four groups according to PASP： control group （〈30mmHg）, mild PH group （30-49mmHg）,moderate PH group （50-69mmHg） and severe PH group （≥70mmHg）. Plasma urotensin I was measured by radioimmunoassay, and plasma nitric oxide was measured by colorimetric assay. Results：The plasma urotensin Ⅱ levels in control group,mild PH group, moderate PH group and severe PH group were （l. 82±0. 83）pmol/L, （2. 86±0.95）pmol/L, （3.38±1.04） pmol/L and （4. 06± 0. 81）pmol/L,respectively. There was marked difference between the normal group and every PH group （P 〈 0.05 ,P 〈 0. 0l） ,and difference in various PH groups （P 〈 0. 05）. The plasma urotensin Ⅱ level was positively correlated with the pulmonary arterial pressure （r = 0. 648,P 〈 0.05）. The nitric oxide level in control group, mild PH group,moderate PH group and severe PH group was （50. 01±9. 79）umol/L, （74. 92±49. 83）umol/L, （75.00±26. 29）umol/L and （72. 32±26. 74）umol/L, respectively. There was marked difference between the normal group and every PH group （P 〈 0. 01） and no difference in different PH groups. The plasma nitric oxide level was not correlated with the pulmonary arterial pressure. Conclusion：With the increase in PH severity,the plasma urotensin Ⅱ level increases. The plasma urotensin Ⅱ plays an important role in the formation of PH and restructure. And the plasma nitric oxide level may play a protective role in the pathogenesis of PH. The plasma urotensin Ⅱ level may be a reliable index to show the change of pulmonary pressure and PH severity.