先心病肺高压患者血浆心钠素在肺部的代谢及意义

A Study on Metabolism and Significance of Plasma Atrial Natriuretic Peptide in the Lung of Patients with Congenital Heart Diseases and Pulmonary Hypertension

探讨心钠素 (ANP)在先天性心脏病肺动脉高压形成中所起的作用。方法 :采用心钠素 (ANP)、环 -磷酸鸟苷(c GMP)特异性放射免疫分析法 ,测定 2 0例先心病肺高压患者 (实验组 )和 9例无心肺疾病者 (对照组 )肺动、静脉血浆 ANP、c GMP的含量 ,对肺部 ANP的变化及其与 c GMP变化的一致性进行分析。结果 :1实验组肺动、静脉血浆 ANP之差高于对照组 ,P<0 .0 5 ;2实验组肺动、静脉血浆 ANP之差及 c GMP之差呈负相关 ,P<0 .0 5 ;3实验组中轻度肺高压组肺动、静脉血浆 ANP之差及 c GMP之差呈负相关 ,P<0 .0 0 1。结论 :1左向右分流的先心病患者血浆 ANP在肺部的代谢量增加 ,可能用于发挥其扩张血管、支气管等作用 ,但在不同程度肺高压时 ,其代谢量有差异 ,提示 ANP在肺部的代谢可能与肺高压的形成有一定的关系。

Aim:To study the effecf of atrial natriuretic peptide(ANP) on the development of congenital heart disease and pulmonary hypertension.Method:The contents of plasma ANP and cyclic guanine monophosphate (cGMP) in pulmonary artery (PA) and pulmonary veini (PV) of 20 patients with left to right shunt congenital heart disease (C.H.D) (experimental group) and 9 without cardio pulmonary disease (control group) were investigated and the correlation of ANP and cGMP was analysed by specific radioimmunoassay.Results:①the difference in plasma ANP between pulmonary artery and vein in the experimental group was higher than that in the control group;②The differences in plasma ANP and cGMP between pulmonary artery and vein of the two groups were negatively correlated;③The differences in plasma ANP and cGMP between pulmonary artery and vein in the exerimental group with moderate and slight pulmonary hypertension were negatively correlated,( P <0.001).Conclusion:The metabolism of plasma ANP in lung increases in patients with left to right shunt C.H.D may be due to its function in dilating the pulmonary vessels,bronchi etc.The degree of ANP metabolism in different groups of pulmonary hypertension is not identical.It suggested that the changes in plasma ANP in lung maybe related with the development of pulmonary hypertension.