先天性心脏病并发肺动脉高压患者血浆血栓素B_2、6-酮-前列腺素F_(1α)和肾素、血管紧张素Ⅱ的变化

CHANGES OF PLASMA TXB_2, 6-KETO-PGF_(1α), ANGIOTENSIN Ⅱ AND RENIN ACTIVITY IN PULMONARY HYPERTENSION SECONDARY TO CONGENITAL HEART DISEASE

对50例左向右分流先心病并发肺动脉高压患者,进行血浆血栓素B_2(TXB_2)与6-酮-前列腺素F_(1a)(6-keto-PGF_(1a))含量以及二者比值(T/6)的测定。结果发现合并肺动脉高压患者的TXB_2与6-keto-PGF_(1a)的平衡失调,PRA(肾素活性)及A_Ⅱ(血管紧张素A_Ⅱ)也有一定改变。

In 50 patients of congenital heart disease with left to right shunt diagnosed by cardiac catheterization and 20 normals, the concentrations of plasma TXB_2, 6-Keto-PGF_10, angiotensin Ⅱ(AⅡ) and plasma renin activity (PRA) were measured, patients were divided into two groups, 20 in the control group with normal pulmonary arterial pressure, 30 in the pulmonary hypertension (PH) group. Furthermore, 30 patients of PH group were divided into three subgroups according to the mean pulmonary arterial plessure (PA), as mild [PA2.67～4.00kPa (20～30mmHg), n=12], moderate[PA4.13～6.67kPa (31～50mmHg), n=6] and severe[PA>6.80kPa (>51mmHg), n=12]. The results revealed that both TXB_2, TXB_2/6-Keto-PGF_1,(T/6)increased in PH (P<0.05). The latter increased in moderate and severe PH (P<0.001 and<0.05, respectively), while the former only increased in severe PH(P<0.001). PRA increased in severe PH (P<0.05). A Ⅱ increased only in mild PH (P<0.05) and was even lower than that of normal in severe PH (P<0.05). It is concluded that:1. There is disorder of TXA_2-PGI_2 in PH secondary to CHD. TXA_2 is a presser agent, T/6 ratio is more sensitive than their absolute concentration in the regulation of pulmonary vascular tone. 2. Renin-angiotensin system may participate in the regulation of pulmonary circulation in PH. A Ⅱ is a vasoconstrictor in some cases of PH. 3. Pulmonary endothelial cell injury may playa very important role in the development ofPH secondary to CHD.