先心病肺高压病儿血浆内皮素与肺组织I、III型胶原含量的相关研究

The relationship between plasma ET-1 and collagen content of lung tissue in patients with congenital heart defect associated with pulmonary hypertension

目的 探讨先天性心脏病 (先心病 )肺动脉高压病儿血浆内皮素 1(ET 1)和胶原增生的相互关系及其在先心病肺动脉高压形成中的作用。方法 2 0例左向右分流型先心病病儿分为肺动脉高压组(PH组 )和无肺动脉高压组 (对照组 ) ,用放射免疫学方法测定两组病儿血浆ET 1水平 ,用SDS 间断聚丙烯酰胺凝胶电泳 (SDS PAGE)测定肺组织I、III型胶原含量。结果 与对照组相比 ,PH组血浆ET 1水平和肺组织I、III型胶原含量明显增加 (P <0 0 1)。PH组血浆ET 1水平与肺组织I、III型胶原含量呈显著正相关。结论 先心病肺动脉高压的形成可能与ET 1水平升高 ,诱导肺组织I、III型胶原增生有关。

Objective: To investigate the relationship between plasma endothelin-1(ET-1) and collagen content in lung tissues in patients with congenital heart defect(CHD) associated with pulmonary hypertension and their effect on the progression of pulmonary hypertension. Methods: 20 patients with left-to-right shunt congenital heart defect were divided into two groups: pulmonary hypertension group (PH group n=11), with preoperative mean pulmonary artery pressure >20?mm?Hg, nonpulmonary hypertension group (control group n=9), with preoperative mean pulmonary artery pressure <20?mm?Hg. In both groups, plasma ET-1 concentration was measured by radio-immunoassay, lung tissues from the right middle lobe were obtained before cardiopulmonary bypass, and type I?III collagen content of lung tissues was measured by SDS-interrupted PAGE. Results: The plasm ET-1 concentration and type I?III collagen contents of lung tissues were significantly increased in the PH group (P<0.01). Correlation analysis revealed that the plasm ET-1 concentration was positively correlated with type I?III collagen contents of lung tissues in the PH group. Conclusion: The elevated plasm ET-1 in patients of CHD may play an important role in pathogenesis of pulmonary hypertension by stimulating type I?III collagen synthesis of the lung tissues.