探讨尾加压素Ⅱ及内皮素在小儿先天性心脏病肺动脉高压中的研究

目的探讨尾加压素Ⅱ（UⅡ）及内皮素（ET）在小儿先天性心脏病（CHD）合并肺动脉高压（PH）患者手术前后的变化以及临床意义，研究肺动脉高压的产生机制。方法61例患者按肺动脉收缩压分为3组。测定3组术前、术后即刻、术后3、7d的AngⅡ及UⅡ含量，并比较手术前后的变化；分析两者与肺动脉压（PAP）间的相互关系。结果3组患者不同时期肺动脉压（PAP）与血浆ET浓度均呈正相关。3组患者UⅡ浓度则与PAP无相关性。术后即刻ET浓度都降低，但是差异无统计学意义（P〉0．05），各组术后ET浓度均呈下降趋势，术后7d和术前相比差异均有统计学意义（P〈0．01）。3组患者手术前后UⅡ浓度差异无统计学意义（P〉0．05）。结论ET在PH形成和血管重建中发挥重要的作用，血浆ET水平可作为判断PH严重程度的指标之一。UⅡ与PAP无相关性，但不能排除UⅡ在PH形成和血管重建中有重要的作用。

Study on the effect of edothelin and urotensin-Ⅱon pulmonary hypertension of congenital heart disease

Objective To evaluate the effect and clinical significance of Edothelin （ET） and urotensin-Ⅱ （U Ⅱ） on pulmonary hypertension（PH）, by detecting their levels of patients with congenital heart disease and pulmonary hypertension. Methods 61 patients with congenital heart disease who had left-to-right shunt were selected randomly 3 groups. The plasma levels of ET and U Ⅱ were detected at each period by radio- immunoassay （RIA） method. It was analyzed the changes of their levels within pre-operation, 20 minutes and 3 days,7 days post-operation and the interrelation between them and PASP. Results Following the severity degree of pulmonary hypertension, the plasma levels of ET increase. There was positive correlation between PAP and plasma level of ET in every time point; Following the severity degree of pulmonary hypertension, the plasma levels of U Ⅱ dont change obviously. There was no correlation between PAP and plasma level of U Ⅱ （ P 〉 0.05 ）. Plasma level of ET of each group was reduced after operation, but the difference was significantly （P 〉 0.05 ）, 7 days post-operation was lower than that of each group before operation, this had statistical difference （ P 〈 0. 01 ）. Plasma level of U Ⅱ of each group after operation was no obvious difference （P 〉 0. 05） o Conclusions Following the severity degree of pulmonary hypertension, the plasma levels of ET increase. ET plays an important role in the formation of pulmonary hypertension and restructure. Following the severity degree of pulmonary hypertension, the plasma levels of U Ⅱ flont change obviously. There is no correlation between PAP and plasma level of U Ⅱ, but UⅡ may be play an important role in the formation of pulmonary hypertension and restructure.