先天性心脏病肺高压患儿血浆肾上腺髓质素浓度的测定及其临床意义:附33例报告

用特异性放射免疫非平衡法测定左向右分流型先天性心脏病 (CHD)患儿血浆肾上腺髓质素 (AM )水平 ,并观察心脏手术后AM的动态变化。结果显示 :CHD肺高压组AM明显高于无肺高压组及正常对照组 (P<0.05 ,P<0.01)。且AM随着肺高压病情加重而升高 ;中、重度肺高压组AM高于轻度肺高压组 ,差异有显著性 (P<0.01)。肺高压组术后AM明显下降 ,与术前比较差异有显著性 (P<0.05 ,P<0.01)。CHD组患儿AM与肺动脉收缩压 (PASP)呈显著正相关 (r=0.77,P<0.05)。本资料表明 ,AM参与了左向右分流型CHD合并肺高压的病理生理过程 ,AM的升高是机体的一种防御性反应 ,对维持肺循环稳定 ,减缓肺高压的发展有积极作用

Detection of the plasma adrenomedullin in children with congenital heart disease associated with pulmonary hypertension and its clinical significance,attached with 33 cases results

To observe the dynamic changes of the plasma adrenomedullin(AM)in children with the congenital heart disease(CHD)associated with pulmonary hypertension(PH)before and after open heart surgery in order to evaluate its clinical significance,the level of the plasma AM was measured in 33 children with CHD and 15 healthy children with the radioimmunoassay in order to analyze the correlation between AM and PASP and compare the dynamic changes before and after open heart surgery.The plasma AM level in children with CHD in non_PH group was significantly higher than that of the control group(P<0.05).The children with CHD in moderate or severe PH groups were apparently higher than that of mild_PH type(P<0.01). But,seven days after surgery,the plasma AM levels in PH group were apparently decreased in comparison with the AM level before surgery showing a great significance(P<0.05).The plasma AM level in children with CHD has positive relationship with PASP(r=0.77,P<0.05).These results indicated that the AM played a very important role in the pathophysiological process in the children with CHD associated with PH.High level of AM may represent a defensive response,so it played an active effect on maintaining the homeostasis of pulmonary circulation and delaying the progress of the pulmonary hypertension.