婴幼儿肺炎合并心衰患者血氧与降钙素基因相关肽及内皮素的相关研究

Study on the correlation between plasma calcltonin gene-related peptide (CGRP) .endothelin (ET) and pre-treated PaO2 level in infants and young children with pneumonia complicated with heart failure

为进一步探讨肺炎并发心衰的机理,观察婴幼儿肺炎合并心衰组(肺炎心衰组)25例,肺炎组26例,对照组25例,检测各组血浆降钙素基因相关肽(CGRP)和内皮素(ET)水平,同时测肺炎心衰组治疗前动脉血氧分压。结果:(1)肺炎心衰组血浆CGRP水平(26.97±19.50ng/L)较肺炎组(51.10±11.42ng/L)及对照组(49.80±11.76ng/L)均明显下降(P<0.01),血浆ET水平(105.95±21.46ng/L)较肺炎组(63.74±17.88ng/L)及对照组(60.34±11.69ng/L)均明显升高(P<0.01)。(2)肺炎心衰组患儿治疗前动脉血氧分压为8.02±2.15kPa,与CGRP水平呈显著正相关(r=0.79,P<0.01),与ET水平呈显著负相关(r=0.65,P<0.01);(3)肺炎心衰组血浆CGRP与ET水平呈显著负相关(r=0.67,P<0.01)。提示重症肺炎患者缺氧致CGRP、ET失衡,是合并心力衰竭的重要机制之一。

To explore the possible pathogenesis of heart failure resulting from pneumonia in infants and young children, plasma calcitonin gene-related peptide (CGRP) .endothelin (ET) and pre-treated PaO2 were determined in 25 cases with pneumonia complicated with heart failure. 26 cases with pneumonia and 25 normal children as control,respectively. The results showed that CGRP level (26. 97±19. 50ng/L) in the group of pneumonia complicated with heart failure was significantly lower than those in the pneumonia group (51. 10±11. 42ng/L) and the normal group (49. 80±11. 76ng/L)(P<0. 01). The plasma ET level (105. 95±21. 46ng/L) in the group of pneumonia complicated with heart failure was obviously higher than those in the pneumonia group(63. 79±17. 88ng/L) and the normal group (60. 34±11. 69ng/L)(P<0. 01). The average of PaO2 was 8. 02±2. 15 kPa which had a significantly positive correlation with plasma CGRP level (r=0. 79,P<0. 01) and negative correlation with ET level (r=-0. 65,P<0. 01) in the group of pneumonia complicated with heart failure. Furthermore, there was a negative correlation (r= -0. 67,P<0. 01) between CGRP and ET levels in the group of pneumonia complicated with heart failure. It is suggested that hypoxic state may result in an imbalance of plasma CGRP and ET regulation, that may play an important role in the pathogenesis of complicating with heart failure in the patients with severe pneumonia.