高原地区肺心病患者血清碱性成纤维细胞生长因子水平与肺动脉压的关系

目的探讨血清碱性成纤维细胞生长因子(bFGF)在低氧性肺动脉高压发病中的作用。方法采用双抗体夹心酶联免疫吸附法(ELISA)检测高原地区(海拔2260~3300m)38例慢性肺源性心脏病(肺心病)急性加重期患者、30例慢性阻塞性肺疾病(COPD)缓解期患者和30例当地健康人血清bFGF含量,并使用彩色多普勒超声心动仪测定肺动脉血流频谱,计算平均肺动脉压(MPAP),使用血气分析仪测定动脉血氧分压(PaO2)。结果肺心病组血清bFGF(87.54±12.15)ng/L、MPAP(45.86±5.63)mmHg(1mmHg=0.133kPa)显著高于COPD组分别为(55.72±9.08)ng/L和(22.95±2.56)mmHg,P均<0.01,COPD组显著高于健康对照组分别为(49.83±8.78)ng/L和(20.34±2.23)mmHg,P均<0.05;肺心病组PaO2(38.79±4.56)mmHg显著低于COPD组(58.22±6.18)mmHg,P<0.01,COPD组则显著低于健康对照组(66.57±5.48)mmHg,P<0.01。肺心病组和COPD组血清bFGF水平与MPAP均呈显著正相关(r肺心病=0.788,rCOPD=0.674,P均<0.01),与PaO2均呈显著负相关(r肺心病=-0.735,rCOPD=-0.587,P均<0.01)。结论慢性肺心病患者血清bFGF水平明显升高,可能与其慢性低氧性肺动脉高压形成有一定关系。

Change in serum basic fibroblast growth factor level and its relationship to pulmonary arterial pressure in patients with acute exacerbation of chronic cor pulmonale on plateau

OBJECTIVE: To assess the role of serum basic fibroblast growth factor (bFGF) in the development of hypoxic pulmonary hypertension in the patients with chronic cor pulmonale on highland (HACCP). METHODS: The levels of bFGF in serum of 38 patients with HACCP in the acute exacerbation stage, 30 patients with chronic obstructive pulmonary disease (COPD) in the remission stageand 30 normal control subjects were measured by sandwich enzyme-linked immunoadsorbent assay (ELISA). The mean pulmonary arterial pressure (MPAP) was measured by echocardiography. The partial pressure of oxygen in artery blood (PaO(2)) was measured by blood gas analyzer. RESULTS: The level of serum bFGF (87.54+/-12.15) ng/L] and MPAP (45.86+/-5.63)mm Hg (1 mm Hg=0.133 kPa)] in the patients with HACCP were significantly higher than those in the patients with COPD (55.72+/-9.08) ng/L, (22.95+/-2.56)mm Hg, respectively, both P<0.01], those of the patients with COPD were bothsignificantly higher than those of the normal control subjects (49.83+/-8.78)ng/L, (20.34+/-2.23)mm Hg, respectively, both P<0.05]. The PaO(2) (38.79+/-4.56)mm Hg] in the patients with HACCP was significantly lower than those in patients with COPD and normal subjects (58.22+/-6.18) mmHg and (66.57+/-5.48)mm Hg, respectively, all P<0.01]. The level of serum bFGF in the patients with HACCP and the patients with COPD was positively correlated with MPAP (cor pulmonale group r=0.788, P<0.01; COPD group r=0.674, P<0.01)],negatively correlated with PaO(2) (cor pulmonale group r=-0.735, P<0.01; COPD group r=-0.587, P<0.01)). CONCLUSION: The level of serum bFGF in patients with HACCP is significantly increased; it may play an important role in the process of sustained hypoxic pulmonary hypertension in patients with HACCP.