先天性心脏病伴肺动脉高压患者血浆内皮素、心钠素的变化及其临床意义

Change and Clinical Significance of Plasma Endothelin-1and Atrial Natriuretic Peptide in Patients With Congenital Heart Disease With Pulmonary Hypertension

目的 :探讨先天性心脏病患者血浆内皮素 1(ET 1)、心钠素 (ANP)浓度的变化及其临床意义。方法 :对 61例先天性心脏病患者 ,其中伴肺动脉高压 (肺动脉高压组 ) 43例 (其中轻度肺动脉高压 2 5例 ,中度肺动脉高压 9例 ,重度肺动脉高压 9例 ) ;肺动脉压正常 (非肺动脉高压组 ) 18例 ,及 16例健康人 (正常对照组 ) ,用放射免疫法测定血浆ET 1、ANP浓度。结果 :①先天性心脏病伴肺动脉高压患者血浆ET 1、ANP浓度较非肺动脉高压组及正常对照组增高 ,有极显著性差异 (P <0 0 1) ,血浆ET 1、ANP浓度随肺动脉高压程度的加重而升高 ,与肺动脉收缩压呈正相关 (γ =0 88、0 78,P <0 0 1) ;② 39例房间隔缺损患者 ,血浆ET 1、ANP浓度与房间隔缺损大小呈正相关 (γ =0 47、0 40 ,P <0 0 5 ) ;③血浆ANP与ET 1浓度呈正相关 (γ =0 82 ,P <0 0 1)。结论 :先天性心脏病伴肺血流量增加及伴肺动脉高压时 ,显示血浆ET 1、ANP浓度升高。

Objective: To assess the change and clinical significance of plasma endothelin 1(ET 1) and atrial natriuretic peptide (ANP) concentrations in patients with congenital heart disease (CHD ) Methods: Plasma ET 1 and ANP concentrations were detected in 61 patients with CHD,including 43 pulmonary hypertension (PH) patients and 18 non PH patients,and other 16 healthy people (controls) by radioimmunoassay Of PH patients,25 had mild,9 moderate and 9 severe PH Results: ①Plasma ET 1 and ANP concentrations in CHD patients with PH were higher than those in patients with non PH and the controls( p <0 01) The severer the PH was,the higher the ET 1 and ANP concentrations ET 1 and ANP concentrations were positively correlated with pulmonary artery systolic pressure ②In 39 patients with atrial septal defect,ET 1 and ANP concentrations were positively correlated with the diameter of the defect ③Plasma ANP concentration was positively correlated with ET 1 Conclusion: CHD accompanined by increased pulmonary blood inflow volume and PH may induce the elevation of the ET 1 and ANP concentrations