经皮二尖瓣球囊扩张术前后血浆降钙素基因相关肽水平研究

为了解经皮二尖瓣球囊扩张术（ＰＢＭＶ）前后血浆降钙素基因相关肽（ＣＧＲＰ）水平，采用放免法测定３０例风湿性二尖瓣狭窄患者ＰＢＭＶ前后的血浆ＣＧＲＰ和内皮素水平，与对照组比较，并与左房内径、二尖瓣口面积和血液动力学参数作相关分析，旨在探讨血浆ＣＧＲＰ水平与二尖瓣狭窄和ＰＢＭＶ的关系。结果显示：术前血浆ＣＧＲＰ水平显著低于对照组（分别为５．６３±１．０１和２２．２９±６．４２ｎｇ／Ｌ，Ｐ＜０．００１），术后第１天明显升高（１２．１５±３．３２ｎｇ／Ｌ，Ｐ＜０．００１），以后继续升高，而血浆内皮素水平则呈相反变化（Ｐ＜０．００１）；ＣＧＲＰ与内皮素的血浆含量呈显著负相关（ｒ＝－０．４２７，Ｐ＜０．０１）；血浆ＣＧＲＰ水平与心脏指数呈显著正相关（ｒ＝０．７０３，Ｐ＜０．００１），与平均肺动脉压、平均右房压和平均左房压呈显著负相关（ｒ分别为－０．６０１、－０．５３５和－０．５９８，Ｐ均＜０．００１）；心功能越差，血浆ＣＧＲＰ水平越低（Ｐ＜０．００１）。提示ＣＧＲＰ在二尖瓣狭窄的病理生理改变中起着重要作用，其血浆水平可作为判断二尖瓣狭窄病情和ＰＢＭＶ疗效的一个指标。

PLASMA LEVELS OF CALCITONIN GENE RELATED PEPTIDE BEFORE AND AFTER PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY

The level of plasma calcitonin gene related peptide (CGRP) in 30 patients with mitral stenosis (MS) was measured before and after percutaneous balloon mitral valvuloplasty (PBMV). The results showed that CGRP level in MS patients was significantly lower than that in controls ( P <0.001) and increased after PBMV( P <0.001); There was significant positive or negetive correlation between CGRP level and cardiac index ( P <0.01) or ET level, mean pulmonary artery pressure, mean right and left atrial pressure ( P <0.001 respectively). It is suggested that CGRP may play an important role in the pathophysiological process of MS, and the level of CGRP before and after PBMV may be a good parameter for evaluating the severity of MS and effect of PBMV.