肾上腺髓质素等与慢性肺源性心脏病、肺动脉高压的关系

目的 探讨肾上腺髓质素(ADM)，脑钠素(BNP)，内皮素(ET—1)，心钠素(ANP)对慢性肺源性心脏病、肺动脉高压的影响及其与缺氧的相互关系。方法 10例慢性肺源性心脏病急性发作患者为A组，10例慢性肺源性心脏病稳定期患者为B组，12例慢性支气管炎患者为C组。3组患者分别空腹采血，用放射免疫法测定ADM、BNP、ET-1、ANP。并抽取桡动脉血送检血气分析，同时采用彩色多普勒测肺动脉压。结果 3组患者肺动脉压及ADM、BNP、ET-1、ANP的含量间差别有显著性意义，且ADM、BNP、ET-1及ANP的含量与肺动脉压呈正相关，与氧分压呈负相关。结论 ADM，BNP，ET-1及ANP在缺氧性肺动脉高压中起重要作用，他们相互作用使肺动脉压达到平衡。ADM及BNP的增高可以对抗ET-1及ANP升高对肺血管的收缩作用，是维持肺循环稳定的代偿机制。提示ADM及BNP可能将成为治疗缺氧性肺动脉高压的一个新药物。

Primary discussion on the relationship between ADM and the pulmonary hypertension of chronic cor pulmonale

Objective This article discusses the influence of ADM,BNP,ET-1 and ANP on pulmonary hypertension of chronic cor pulmonale and studies the interrelation between them and anoxia.Methods Group A consisted of ten cases of acute outbreak of chronic cor pulmonale, group B consisted of ten cases of chronic cor pulmonale in stable phase and group C consisted of ten cases of chronic bronchitis.Sample blood of all patients with empty stomach was taken and measured the ADM,BNP,ET-1 and ANP by radioimmunoassay.Sample blood of radial artery and blood gas analysis were carried out and measured the pressure of pulmonary artery through color Doppler.Results There is marked difference between the averages of the pressure of pulmonary artery,ADM,BNP,ET-1 and ANP in three groups,and the correlation between the ADM,BNP,ET-1,ANP and the pressure of pulmonary artery is positive while between the ADM,BNP,ET-1,ANP and PaO 2 it is negative.Conclusion ADM,BNP,ET-1 and ANP have an important effect on anoxic pulmonary hypertension because the balance of the pressure of pulmonary artery is the result of the interaction between them.The increase of ADM and BNP can counteract obviously the contraction of the pulmonary vessels caused by the increase of ET-1 and ANP.Through this compensatory mechanism,the stabilization of pulmonary circulation is achieved.The result shows that ADM and BNP may be the new medicine for anoxic pulmonary hypertension.