肺动脉高压新生儿血浆硫化氢变化的意义

Changes of Endogenous Hydrogen Sulfide in Plasma of Newborn Infant with Pulmonary Hypertension

目的探讨肺动脉高压新生儿血浆硫化氢（H2S）的变化及其与肺动脉高压（PH）相关性，为临床有效治疗新生儿PH提供新的思路和理论依据。方法随机选取2005年3月-2006年3月本院ICU病房住院PH新生儿16例，选取同期住院非PH新生儿16例作为对照组。对全部研究对象均行超声心动图检查，依据简化柏努力方程ΔP=4V^2 max计算出压力阶差，估测三尖瓣二侧压力，间接判断其肺动脉压，对二组新生儿于出生3～10d清晨8：00取静脉血4mL，迅速分离其血浆，采用敏感硫电极法测定其血浆H2S水平，应用氨基酸分析仪测定其同型半胱氨酸水平。应用SPSS10．0软件进行t检验。结果PH新生儿肺动脉收缩压为4．27～9．73（6．49±1．79）kPa；对照组肺动脉收缩压正常。肺动脉高压组血浆同型半胱氨酸及H2S水平明显高于对照组[（11．94±6．65）μmol／L vs（6．43±2．08）μmol／L，t=2．630P=0．016；（26．99±1．33）μmol／LV．S（24．92±1．36）μmol／L，t=4．373 P=0]。结论PH新生儿血浆同型半胱氨酸和H2S明显升高，内源性H2S上调可能参与肺动脉压力的调节。H2S可能通过扩张肺动脉降低肺动脉压力而对PH具有保护作用。

Objective To explore the changes of hydrogen sulfide （ H2S） levels in plasma of newborn infants with pulmonary hypertension （PH） and its relationship with pulmonary hypertension, and provide scientific evidence for the decision of treating neonatal PH. Methods Sixteen children with PH and 16 children without PH in ICU from Mar. 2005 to Mar. 2006 were selected. Ultrasonic cardiogram（UCG） examination was performed for eachpatients. Pulmonary artery pressure（PAP） was measured. The plasma concentrations of H2S, cysteine and PAP of each patient were measured. Results PAP was 4.27 -9.73 kPa[ （6.49 ±1.79） kPa] in neonatal PH group,and PAP in control group was normal. The plasma levels of cysteine and H2S in neonatal PH group significantly increased compared with those of control group [（11.94±6.65） μmol/Lvs （6.43±2.08）μmol/L,t =2. 630 P=0.016;（26.99±1.33） μmol/Lvs （24.92±1.36）μmol/L,t= 4. 373 P =0]. Conclusions Endogenous H2S and cysteine were up - regulated during the development of neonatal PH; it might play an improtant role in the development of PH. H2S possibly depress the PAP by dilating the pulmonary artery to protect the patients with pulmonary lay pertension.