肾上腺髓质素与缺氧性肺动脉高压的关系

目的本研究探讨缺氧对肾上腺髓质素(AM)合成分泌的影响及AM在缺氧性肺动脉高压中的作用和意义。方法制备大鼠缺氧性肺动脉高压模型，分为对照组和缺氧组(10，20，30d)。每组6只。慢性肺心病患者23例，对照组16名。测量肺动脉压力和右心室收缩最大上升速率。应用放射免疫法检测血浆和支气管肺泡灌洗液中AM含量的动态变化。测定慢性肺心病患者急性期和缓解期血浆AM含量变化。结果缺氧组实验大鼠肺动脉压和右心室最大上升速率高于对照组(P<0.01)；血浆和支气管肺泡灌洗液中AM含量高于对照组(P<0.01)，且与肺动脉高压变化趋势一致。慢性肺心病患者不同病期血浆AM亦明显高于对照组(P<0.01)。结论AM参与缺氧性肺动脉高压的病理生理过程，在肺血管张力调节中起重要作用。局部和全身性AM增高可能是机体自身内源性抗损伤的代偿反应。

Adrenomedullin and hypoxia-induced pulmonary hypertension

Objective To study adrenomedullin (AM) in rat and human lung during hypoxia induced pulmonary hypertension.Methods Normobaric hypoxic pulmonary hypertension animal model was adopted,pulmonary artery pressure and RVdp/dt were measured. The changes of AM contents in blood and bronchoalveolar lavage fluid were studied.The plasma levels of AM in patients with pulmonary hypertension were measured.Results During hypoxia,pulmonary artery pressure, RVdp/dt ,AM contents in blood and bronchoalveolar lavage fluid in rats increased. Plasma levels of AM were significantly higher in patients with pulmonary hypertension than in the control subjects.Conclusions AM may play an important role in developing hypoxic pulmonary hypertension in rats and human. The increase of AM level is in proportion to the extent of pulmonary hypertension.