高原肺水肿患者内皮细胞源性因子改变与肺动脉高压关系的研究

目的　探讨肺动脉内皮细胞源性舒缩因子 (Endotheliumderivedrelaxingandconstrict ingfactor )在高原肺水肿 (HAPE )肺动脉高压发生中的作用。方法　采用右心漂浮导管检测法 ,对 8例高原肺水肿患者及 8例同海拔高度高原健康人的肺动脉压力进行了检测 ,同时也采用放免分析方法检测了HAPE患者肺动脉内皮细胞分泌到血液中的收缩因子ET - 1、TXA2 及舒张因子NO、PGI2 变化。结果　HAPE患者发病时 ,肺动脉平均压明显高于同海拔高度健康人 ,而血PaO2 、SaO2 明显低于对照组 ;HAPE患者外周血ET - 1、TXA2 含量明显高于对照组 ,而血中NO、PGI2 水平明显低于对照组 ;患者肺动脉平均压同ET - 1 /NO及TXA2 /PGI2 比值呈显著正相关。结论　肺动脉内皮细胞分泌的内皮源性舒缩因子失衡在高原肺水肿的缺氧性肺动脉高压发生中起重要作用

STUDY ON THE RELATION BETWEEN THE CHANGE OF ENDOTHELIAL CELL ENDOTHELIUM DERIVED FACTORS IN PATIENTS WITH HIGH ALTITUDE PULMONARY EDEMA(HAPE) AND THE HYPOXIC PULMONARY ARTERY HYPERTENSION(HPAH)

Objective To investigate the role of pulmonary artery endothelium derived relaxing and constricting factor in machanism of developing HPAH in patients with HAPE. Methods The pulmonary arterial pressure were measured by Swan-Ganz thermistor catheters in 8 patients with HAPE, high altitude healthy volunteers as controls. The contents of plasma Endothelin-1 ( ET-1 ), Nitric oxide ( NO ), Thromboxane A 2 ( TXA 2 ), Prostacyclin ( PGI 2 ) were determined by radioimmuno-analysis technique. Results The mean pulmonary arterial pressure ( mPAP ) in HAPE significantly increased compared with controls, while the PaO 2 and SaO 2 of HAPE significantly decreased compared with controls; The contents of plasma ET-1 and TXA 2 were significantly higher than those of controls, while the contents of plasma NO and PGI 2 were significantly lower than those of controls; The mPAP of HAPE was obviously postively correlated to ET-1/NO and TXA 2/PGI 2 ratio. Conclusion The abnormal secretion of pulmonary artery endothelium derived relaxing and constricting factors may play an important role in the developing HPAH in patients with HAPE.