慢性阻塞性肺病急性加重期患者血清内皮素、一氧化氮昼夜变化特点及与动脉血气的临床研究

Research on plasma endothelin-1,nitrousoxide levels,blood gas analysis in patients with chronic obstructive pulmonary disease

目的探讨血浆内皮素-1(ET-1)、一氧化氮(NO)在慢性阻塞性肺病(COPD)发生、发展中的作用,观察其昼夜变化及动脉血气的变化。方法检测75例COPD患者血中清晨1AM、6AM的ET-1和NO水平,并结合临床分级另抽取6AM动脉血检测血气,并与30例正常对照组比较。结果Ⅱ、Ⅲ级COPD患者ET-1水平明显高于Ⅰ级COPD患者和正常人(P<0.05),而NO水平明显降低。COPD患者血中ET-1分别与PaO2SaO2、pH呈负相关(P<0.05),而与PaCO2呈正相关(P<0.05);NO分别与pH、PaO2呈正相关(P<0.05)。且随着COPD病情进展Ⅰ级～Ⅲ级,ET-1、PaCO2逐渐增高,而NO、PaO2、SaO2逐渐降低。结论ET-1和NO是参与COPD急性期发病过程的重要因素。

Objective To explore the effect of endothelin - 1 and nitrousoxide in the development and progression of diseese and observe their change of day and night and blood gas analysis. Methods Plasms ET - 1 and NO level of 75 COPD patients and 30 healthy subjects were detected in 1 AM and 6AM,as we tested their blood gas analysis in 6AM. Results In n, m grade COPD patients, the plasma ET - 1 levels were higher than that of 1 grade patients and healthy subjects （P 〈 0.05 ）, the NO levels were lower than them. The ET- 1 levels in COPD patients were correlated negatively with PaO2 ,SaO2 ,pH and positively with PaCO2 （ P 〈 0.05 ）, the plasma NO levels were correlated positively with PaO2 ,SaO2 and pH （ P 〈 0.05 ）. From I grade to m grade in COPD patients, plasma ET - 1 ,PaCO2 increased and NO ,PaO2 decreased gradudly. Conclusions Endothelin - 1 and nitrousoxide are important factors of exacerbrating diseases in acute phase in patients with COPD.