经皮二尖瓣球囊成形术对N-心钠素 和降钙素基因相关肽分泌的影响

探讨经皮二尖瓣球囊成形术（ＰＢＭＶ）对Ｎ－心钠素（Ｎ－ＡＮＰ）和降钙素基因相关肽（ＣＧＲＰ）分泌的 影响。方法：研究了２４例二尖瓣狭窄（ＭＳ）患者ＰＢＭＶ前后血浆Ｎ－ＡＮＰ和ＣＧＲＰ浓度的变化，两者的相关性，并研 究了Ｎ－ＡＮＰ与平均二尖瓣跨瓣压差（ＭＭＰＧ）、二尖瓣口面积（ＭＶＡ）、左房内径（ＬＡＤ）及血流动力学参数作相关分 析。结果：患者术前血浆Ｎ－ＡＮＰ浓度高于对照组（Ｐ＜０．００１），术后显著下降（与术前比较，Ｐ＜０．００１），但仍高于 对照组（Ｐ＜０．００１）；而ＣＧＲＰ水平则呈相反变化，Ｎ－ＡＮＰ与ＣＧＲＰ的血浆水平呈显著负相关（ｒ＝－０．４７２５，Ｐ＜ ０．０５）。血浆Ｎ－ＡＮＰ改变量（△Ｎ－ＡＮＰ）与ＭＭＰＧ改变量（△ＭＭＰＧ，ｒ＝０．６７７０，Ｐ＜０．００５）、ＬＡＤ的改变量（△ＬＡＤ，ｒ＝ ０．４７０４，Ｐ＜０．０２５）及平均左房压改变量（△ＭＬＡＰ，r＜＝０．７２７２，Ｐ＜０．００５）均呈正相关，与ＭＶＡ的改变量（△ＭＶA）呈 负相关（ｒ＝－０．６４５１，Ｐ＜０．００５）。结论：Ｎ－ＡＮＰ和ＣＧＲＰ在ＭＳ引起的病理生理改变中起重要作用，测定Ｎ－ＡＮＰ 和ＣＧＲＰ变化有可能作为判定ＮＳ狭窄程度及Ｐ?

The effect of percthaneous balloon mitral valvuloplasty on the secretion of N-terminal atrial natriuretic peptide and calcitonin gene-related peptide

To assess the effect of pereutaneous balloon mitral valvulpolasty (PBMV) on the secretion of Nterminal atrial natriaretic peptide (N-ANP) and calcitonin gene-related peptide (CGRP). Methods: Plasma N-ANP and CGRP were measured before and after PBMV in 24 patients with mitral stenosis (MS). Correlation was performed betten NANP and CGRP Also, linear correlatlons were performed between N-ANP concentrations and mean mitral pressure gradient (MMPG). mmitral valve areas (MVA),left atrial diameter (LAD) and hemodynamic parameters. Results: plasma N-ANP levels in patients before PBMV were significatly higher than the control group (P<0.001). plasma N-ANP levels after PBMV were decreased significantly (P<0.001). while they were markedly higher than. the controls (P<0.001 ). The palsma level of CGRP turned out contrary to the N-ANP. There were negative correlation between them. There were positive correlations be tween N-ANP variations (△N-ANP) and MMPG variations (△MMPG, r =0.6770, P<0.005). LAD variations (LAD, r= 0.4704, P<0.025), and mean left atrial pressure variations (MLAP), r=0.7272, P<0.005) . There was a negative correlation between N-ANP variations (△N-ANP) and MVA variations (MVA (r = -0.6451, P<0.005). Conclusion: There results suggest that N-ANP and CGRP, plays important roles in pathogenesis of mitral stenosis. N-ANP and CGRP may be useful markers to reflect the degree of mitral stenosis and curative effect of PBMV.