慢性肺心病患者血清一氧化氮（NO）的表达水平与右心室肥大程度的关联研究

目的探讨慢性肺心病患者血清N0含量的变化及意义，揭示与肺心病的病程发展和右心室肥大程度的关联性，并为临床上治疗慢性肺心病肺动脉高压提供一个新思路，也为慢性肺心病的防治寻找新的途径。方法42例慢性肺心病患者，平均年龄（64．5±11．8）岁，其中男14例，女28例，根据病情分为急性加重期组和缓解期组，另选年龄、性别相匹配的40例健康人为对照组。用化学比色法测定血清NO水平，用心脏彩超检查测定肺动脉收缩压（PASP）、室间隔厚度（IVST）、右室前壁厚度（RVAW）和右室舒张末期内径（RVEDd）。同时行动脉血气分析测定PaO2、PaCO2，统计分析NO与慢性肺心病的病程发展和右心室肥大程度的关联性，进一步丰富慢性肺心病的发病机制。结果慢性肺心病急性加重期组血清NO水平（71．25μmol／L，中位数）明显高于对照组[41．53Iμmol／L，P〈0．01]；肺心病患者NO水平与PaO2、PaCO2并无相关性，但与吸烟存在相关性。结论肺心病患者在急性发作期，血清NO水平明显升高，其比值失衡可能是肺心病发病机制之一。

Objective To explore the change of serum level of nitric oxide（NO） expression and its clinical significance in chronic pulmonary heart disease patients, and to study its correlation to the progress of the desease and the degree of fight ventricular hypertrophy, therefore trying to explore a potential new treatment for chronic pulmonary heart disease. Methods 42 patients of chronic pulmonary heart disease were divided into two groups, acute exacerbation stage group and remission stage group according to the status of the illness; another 40 healthy people with according age and sex were as control. Colorimetric technique was used to determine the serum level of NO, Pulmonary arterial systolic pressure（PASP） ,interventricular septal thickness （IVST）,right ventricular 右室 anterior wall （RVAW） and right ventricular end diastolic diameter（RVEDd）were measured with ultrasonic cardiogram, and arterial blood gas analysis was used to measure PaO2 ,PaC02. The correlation of NO to the progress of the chronic pulmonary heart disease and the degree of right ventricular hypem-ophy was studied statistically, and its relationship to the pathogenesis of chronic pulmonary heart disease was explored too. Results Serum level of NO （71.25μmol/L,median）was significantly higher than that in control group[41.53μmol/L,P 〈0. 01 ], serum level of NO was not correlated to the Pa02, PaCO2, but correlated to the presence of smoking. Conclusions Serum NO level increases significantly during the acute exacerbation stage of chronic pulmonary heart disease and the disbalance might be one of the pathogenesis.