肺心病患者血中心钠素、血管紧张素转换酶含量与肺血流动力参数关系

测定34例肺心病患者血中ANP、ACE含量并同时观测其中19例肺心病肺血流动力参数。结果显示:(1)肺心病患者周围静脉血中ANP较正常人高,急性期高于缓解期,ACE较正常人低,急性期与缓解期无显著差别;(2)肺动脉血中ANP及ACE含量显著高于周围静脉血;(3)右房压高者血中ANP高于右房压正常者,右房压正常者血中ANP与正常人无显著差异,血中ANP含量与肺动脉压及右房压具显著正相关性,血中ACE含量与肺动脉压及右房压无显著相关性。这提示肺心病肺动脉压影响心脏分泌ANP,右心房压力增高是血浆ANP增多的主要原因,血中ACE含量不受肺血流动力参数变化影响。

RELATIONSHIP BETWEEN BLOOD ANP, ACE, AND PULMONARY HEMODYNAMICS IN PATIENTS WITH CHRONIC COR PULMONALE

To investigate the relationship between blood ANP, ACE,and pulmonary hemodynamics in patients with chronic cor pulmonale (CCP), w(?) measured blood ANP and ACE in 34 patients and pulmonary hemodynamics in 19 patients. The results showed: 1. Plasma ANP levels were significantly higher and serum ACE levels were significantly lower in the CCP group than those in the healthy group. 2. Blood levels of ANP and ACE were higher in pulmonary artery than those in peripheral vein. 3. Plasma ANP levels were higher in the group of elevated right atrial pressure (Rap) than those in the group of normal Rap. There was no significant difference in plasma ANP levels between healthy group and the subgroup of CCP with normal Rap. A highly significant positive correlation between plasma ANP level and pulmonary arterial pressure (PAP) was found. Significant positive correlation was also found between plasma ANP level and Rap. 4. There was no significant difference in serum ACE level between groups of elevated and normal Rap. No significant correlation between serum ACE level and PAP or Rap was found. These results suggests PAP may play an important role in ANP release from cardiac atria and ANP release in response to increased PAP is caused by elevated Rap. The variations of pulmonary hemodynamics do not affect serum ACE level.