慢性肺心病血浆环核苷酸及内皮素-1含量变化的临床研究

目的观察慢性肺原性心脏病(慢性肺心病)急性期血浆环核苷酸和内皮素-1的含量变化与临床的关系。方法用放射免疫法检测了35例正常对照和42例慢性肺心病急性期及合并多脏器损害病人血浆的cAMP、cGMP含量及其比值的改变和24h血浆内皮素1(ET-1)的含量。结果急性发作期血浆cAMP明显高于对照组及缓解期(P<0.05),但缓解期与对照组比较则无明显差异;血浆cGMP在急性期和缓解期均高于对照组(P<0.05),两者之间则无统计学上的差异(P>0.05);急性期、缓解期cAMP/cGMP比值均低于对照组(P均<0.05)。合并多脏器损害病人的血浆cAMP下降(P<0.05),cGMP上升(P<0.05),cAMP/cGMP比值下降(P<0.05)。而病人24h中各时段的血浆内皮素-1值均显著高于正常对照组(P分别<0.01和0.05),经治疗后血浆ET-1含量下降(P<0.05)。结论检测慢性肺心病患者血浆环核苷酸的变化有助于合并多脏器损害的诊断,而血浆内皮素-1的24h改变有助于对病情的监测。

The Clinical Investigation of Plasma Endothelin-1 and Cyclic Nucleotide Acid in the Patients With Chronic Cor Pulmonale

Objective To investigate the correlation between the clinical conditions and the change of the levels of plasma endothelin-1 (ET-1) and plasma cyclic nucleonde acid in the patients with chronic cor pulmonale during acute phase. Methods 24h radioimmunoassay(RIA) measurements of plasma ET-l,cAMP and cGMP levels and cAMP/cGMP odds were performed in 35 healthy volunteer and 42 patients with chronic cor pulmonale during acute phase, remission phase, and complicated with multiple organ dysfunction (MOD) . Results Plasma cAMP levels were significantly higher in the patients with cor pulmonale during acute phase than those of control group( P < 0.05) , and those of remission phase( P < 0.05) . Plasma cAMP levels showed no significant difference between the control group and those during remission phase. The cGMP levels were significantly higher in the patients during acute phase and remission phase than the normal control ( P < 0.05) . However the cGMP levels were the same in the patients during acute phase and remission phase. But the plasma cAMP/cGMP odds were significantly lower in both patients during acute phase and remission phase than those of the control group( P < 0.05) . In the patients with chronic cor pulmonale complicated with MOD, the plasma cAMP levels were decreased ( P < 0.05), plasma cCMP levels increased( P < 0.05), and cAMP/cGMP odds were decreased( P < 0.05). The plasma ET-1 levels at various time of 24 hours were significantly higher in the patients with cor pulmonale than those of the control group( P < 0.01) . Plasma ET-1 levels in the patients with cor pulmonale than those of the control group( P < 0.01) .Plasma ET-1 levels in the patients were decreased after treatment( P < 0.05) . Conclusion Detecting plasma cyclic nucleotide acid in the patients with chronic cor pulmonale could help to diagnose cor pulmonale complicated with MOD. The changes of plasma ET-1 levels during 24 hours could be used to evaluate the condition of the patients with chronic cor pulmonale.