经皮二尖瓣球囊扩张术对内皮素及其他内分泌激素的影响

Effect of percutanous transluminal balloon mitral valvuloplasty on endothelin and endocrine hormones

目的 探讨风湿性心脏病二尖瓣狭窄患者在行经皮二尖瓣球囊扩张术 (PBMV)前后内皮素 (ET)以及其他内分泌激素变化的意义。方法 14例风湿性心脏病二尖瓣狭窄患者作PBMV的前后测定血浆ET、心钠素 (ANF)、肾素 (PRA)、血管紧张素Ⅱ (AⅡ )以及血流动力学参数。结果 在PBMV前血浆ET(16 1.94± 5 0 .6 1) pg/ml[术后为 (80 .4 0± 19.13)pg/ml,P <0 .0 0 1];ANF(2 39.34± 87.0 0 )pg/ml[术后为 (10 5 .0 0±4 1.4 6 )pg/ml,P <0 .0 1];PRA(3.2 7± 1.0 5 )pg/ml[术后为 (1.38± 0 .78)ng/ml,P <0 .0 1];AⅡ (16 1.2 6± 36 .4 5 4 ) pg/ml[术后为 (89.4 4± 2 3.70 )pg/ml,P <0 .0 0 1],均较手术前明显降低 ,但仍显著高于对照。PBMV后ET的变化 (ΔET)与左房压 (ΔLAP)、二尖瓣跨压差 (ΔMPG)、二尖瓣面积 (ΔMAV)以及峰值流速 (ΔPV)变化有显著相关性。结论 本研究证实PBMV扩大瓣口面积使LAP下降 ,ET等其他内分泌激素含量随之下降 。

Objective To study the effect of percutanous transluminal balloon mitral valvuloplasty(PBMV) on endothelin and endocrine hormones. Methods Plasma concentrations of endothelin(ET), atrial natriuretic factor(ANF), renin activity(PRA), angiotension Ⅱ(AⅡ) and hemodynamic changes were assessed in 14 patients with rheumatic mitral stenosis before and after PBMV. Results After the procedure, ET(80.40±19.13 pg/ml vs 161.94±50.61 pg/ml, P <0.001), ANF(105.00±41.46 pg/ml vs 239.34±87.00 pg/ml, P <0.01), PRA(1.38±0.78 ng/ml vs 3.27±1.05 ng/ml, P <0.01) and ATⅡ(89.44±23.70 pg/ml vs 161.26±36.45 pg/ml, P <0.001) levels were significantly reduced. Conclusions The study indicates that LAP and plasma hormone levels were decreased after successful PBMV and the degree of changes in hemodynamics and hormones was closely related.