白花前胡提取物对缺氧性肺动脉高压病人血浆内皮素—1的影响

目的：探讨内皮素－1（endothelin-1,ET-1)在慢性缺氧必肺动脉高压发生中的作用及白花前胡提取物（QF－8）降低肺动脉高压作用机制。方法：分别用右心漂浮导管法和放射免疫法同步检测11例慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD)继发性肺动脉高压患者口服QF－8前、后血流动力学指标和体静脉、肺动脉及体动脉血浆ET－1水平。结果：COPD患者体静脉ET－1水平显著高于正常对照组体静脉（P＜0．01）、自身肺动脉（P＜0．05）及自身体动脉（P＜0．01）血浆ET－1水平，且血浆（包括体静脉、肺动脉及体动脉）ET－1水平均与PaO2呈显著负相关，与肺血管阻力指数（pulmonary vascular resistance index,PVRI)呈显著正相关。口服QF－8后，肺动脉压力和PVRI明显下降，同时血浆ET－1水平亦呈不同程度下降，其下降幅度依次为体静脉（25％）＞肺动脉（21％）＞体动脉（10％），与血浆ET－1水平升高顺序一致。结论：ET－1的合成或分泌功能异常可能参与了慢性缺氧性肺动脉高压的形成，QF－8降低肺动脉高压作用与抑制ET-1成或分泌的某些环节有关。

Effect of Extract from Baihua Qianhu on the Plasma Endothelin-1 in Patients with Hypoxic Pulmonary Hypertension

Objective: Our aim was to study the effect of endothelin-1 (ET-1) on the development of chronic hypoxic pulmonary hypertension and mechanism of QF-8 (the extract of baihua qianhu, a Chinese traditional medicine) in lowering pulmonary hypertension. Methods: The indexes of hemodynamics and the levels of plasma ET-1 in systemic vein, pulmonary artery, and systemic artery in 11 patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease (COPD) were measured with right-heart catheterization and radioimmunoassay. Results: The ET-1 level in patients was significantly higher in systemic vein than that in 15 controls (P<0.01), pulmonary artery (P<0.05), and systemic artery (P<0.01). The levels of plasma ET-1 in patients had significant negative correlation with PaO2 and positive correlation with pulmonary vascular resistance index (PVRI). After taking QF-8, mean pulmonary artery pressure (mPAP) and PVRI significantly decreased, meanwhile, the levels of plasma ET-1 in systemic vein, pulmonary artery, and systemic artery also decreased by 25%, 21%, and 10%, respectively. Conclusion: Abnormality in synthesis or secretion of ET-1 may play a role in the development of chronic hypoxic pulmonary hypertension. The effect of QF-8 on pulmonary hypertension in patients with COPD may be related with its inhibition on the synthesis or secretion of ET-1.