先天性心脏病肺动脉高压患儿血浆ET-1、CGRP、TXA_2及肺组织中其受体的变化

Changes of plasma ET-1,CGRP,TXA_2 and their receptor expression in lung tissue of children with congenital heart disease-associated pulmonary artery hypertension

目的探讨左向右分流型先天性心脏病合并肺动脉高压患儿血浆内皮素-1(ET-1)、降钙素基因相关肽(CGRP)及血栓素A2(TXA2)的变化及其受体在肺组织中的变化。方法采集60例左向右分流型先天性心脏病患儿血浆,采用酶免、放射性免疫及ELISA等方法测定ET-1、CGRP和TXB2含量,修补术中取患儿肺组织,采用RT-PCT的方法检测相应受体在肺组织中的表达变化。结果与对照组相比,观察组(先天性心脏病组)患儿血浆ET-1及TXB2的水平明显增高(P<0.05),而血浆CGRP的含量水平则明显降低(P<0.01);与无肺动脉高压组患儿相比中、重度肺动脉高压患儿血浆ET-1和TXB2的含量显著增高,而CGRP的含量则显著降低(P<0.05,P<0.01);经过PGE1治疗14 d后,患儿血浆ET-1和TXB2的含量显著降低(P<0.01),而CGRP的含量则无明显变化(P>0.05)。与无肺动脉高压组患儿相比合并肺动脉高压患儿肺组织中ET-1和TXA2受体的mRNA表达显著增高,而CGRP受体的mRNA表达量则显著降低(P<0.05,P<0.01)。结论ET-1、CGRP和TXA2与左向右分流型先天性心脏病合并肺动脉高压的发生与发展有着密切的联系,且测定这些指标可以用来判断其预后。

Objective To study the changes of plasma ET-1, CGRP, TXA2 and their receptor expression in lung tissue of children with congenital heart disease-assicated pulmonary artery hypertension. Methods Plasma was collected from 60 children patients. ET-1, CGRP and TXB2 levels were measured by EIA, RIA and ELISA, respectively. Expression of their receptors in the lung tissue was detected by RT-PCR. Results The plasma ET-1 and TXB2 levels were significantly higher in CHD patients than in control children. The plasma CGRP level was significantly lower in CHD patients than in control children. Fourteen days after treatment with PGE1, the plasma ET-1 and TXB2 levels were significantly decreased with no significant changes in CGRP. The expression level of ET-1 and TXA2 receptor mRNA was significantly higher in patients with pulmonary artery hypertension than in those without pulmonary artery hypertension. However, the expression of CGRP receptor mRNA was lower in patients with pulmonary artery hypertension than in those without pulmonary artery hypertension. Conclusion Plasma ET-1, CGRP and TXA2 levels are closely related with congenital heart diseaseassociated pulmonary artery hypertension, and can be used as an index for its prognosis.