肺心病并发呼吸衰竭时血管紧张素及其酶系统的改变

Changes in Angiotensin Ⅱ and its Enzyme in the Cor Pulmonale with Respiratory Failure

研究了肺心病合并Ⅱ型呼衰病人,健康人及慢阻肺病人的血管紧张素Ⅱ(ATⅡ),血管紧张素转换酶(ACE)与肾素活性(PRA).结果呼衰组ATⅡ升高,ACE 下降而 PRA 则升高;死亡病例 ATⅡ高于缓解者;氧疗后病人 ATⅡ及 ACE 降低;PRA 也有下降趋势。呼衰组 ATⅡ及 ACE 与 PaO_2密切相关。由此认为低氧时人体对高 ATⅡ反应之一是 ACE 下降,呼衰者 PRA 高且 ACE 下降不足使 ATⅡ增高。ATⅡ水平与病情变化相关,单纯氧疗不能降至正常范围。用抑制 PRA 及 ACE 方法降低 ATⅡ水平及用 ATⅡ为病情追踪指标有实际意义。

Angiotensin Ⅱ(ATII),Angiotensin-converting enzyme(ACE)and plasma renin activity(PRA)were measured in cor pulrnonale with type Ⅱ respiratory failure,healthy people and COPD patients.The result showed ATII and PRA were higher and ACE was lower in respiratory failure group than in the other two.ATII in the dead was higher than that in the remi- tent.After oxygen treatment all paramenters were lower.ATII and ACE were closely related to PaO2.It has been concluded that during hypoxemia one of the responses to high ATII in the human body is the decrease of ACE. But both the increase of PRA and the insufficient decrease of ACE in the cot pulmonale with respiratory failure result in the increase of ATII.Also the ATII level might be an indicator of the prognosis.