经皮球囊二尖瓣成形术前后一氧化氮、内皮素变化的研究

目的探讨风湿性心脏病二尖瓣狭窄患者经皮球囊二尖瓣成形术(PBMV)前后肺动脉及左心房血浆中内皮素(ET)、一氧化氮(NO)变化。方法选择符合行PBMV适应证的风湿性二尖瓣狭窄患者50例，PBMV术前及术后30min监测肺动脉压、左心房压，并同时取肺动脉血、左心房血分别用重氮法和放射免疫法测定NO和ET值及NO／ET值。结果PBMV术后，肺动脉压、左心房压明显下降，肺动脉平均压由((51．7±19．3)mmHg(1mmHg＝0．133kPa)降至(21．5±7．0)mmHg(P＜0．01)，左心房平均压由(25．3±6．7)mmHg降至(13．2±9．7)mmHg(P＜0．01)。术前左心房血浆ET(51．1±10．6)pg/ml，NO(99．6±9．4)μmol／L，NO／ET=1．95±1．12；肺动脉血浆ET(131．1±19．3)pg/ml，NO(165．4±50)μ

The changes of NO and ET in plasma before and after percutaneaus mitral balloon valvuloplasty

Objective To observe the changes of nitric oxide(NO) and endothelin(ET) in plasma of pulmonary artery and left atrium before and after percutaneaus balloon mitral valvuloplasty(PBMV) in patients with rheumatic mitral stenosis. Methods Fifty patients with rheumatic mitral stenosis were be selected to perform PBMV. Before and 30 min after PBMV we monitored the pulmonury mean pressure. Left atrial mean pressure and measured the levels of NO and ET in plasma of pulmonary artery and left atrium were at same time. Results After PBMV, the pulmonary and left atrium pressure were markedly decreased(the pulmonary mean pressure from(51.7?9.3)mm Hg to(21.5?.0)mm Hg, the left atrial mean pressure from(25.3?.7)mm Hg to(13.2?.7)mm Hg(P<0.01) respectively. The levels of NO and ET in plasma of pulmonary artery and left atrium weresignificant lower ET(139.1±19.3)pg/ml vs. 87.5±14.9pg/ml, NO(165.4±15.0)μmol/L vs. (122.83±11.77)μmol/L, NO/ET 1.26±0.78vs. 1.41±0.79 in pumonary artery; ET(51.1±10.6)pg/ml vs. (31.1±8.1)pg/ml, NO(99.64±9.40)μmol/L vs.(70.3±10.1)μmol/L, NO/ET(1.95±1.12) vs (2.26±1.23) in left atrium, P<0.01 respectively). There was a significant rrelation between the lelvel of ET and pulmonary pressures(r=0.47, P≤0.05). Conclusion After PBMV the level of NO nd ET in plasma of left atrium and pulmonary artery were markedly decreased with the decrease of ulmonary and left atrial pressure. The level of ET in plasma was correlated with the pulmonary mean pressure.