降钙素基因相关肽与肺动脉高压右室功能相关关系的研究

目的　探讨降钙素基因相关肽 (CGRP)在肺动脉高压 (PH )右室功能损害、右室重塑病理生理过程中的作用和相关关系。方法　分别对PH组 (5 8例 ) ,非PH组 (2 3例 ) ,对照组 (2 0例 )进行超声心动图三尖瓣前向血流及反流频谱、肺动脉前向血流频谱测定。结果　PH组与非PH组及正常对照组相比 ,E、E/A显著降低 ,A增加 ,PV显著降低 ,IRT、ICT显著延长 ,Tei指数显著增加 (P均 <0 .0 1) ;CGRP浓度显著降低 ,与肺动脉收缩压呈负相关 (r =-0 .73 5 ,P <0 .0 1) ,与E、E/A、PV呈正相关 (r分别为 0 .792 ,0 .762 ,0 .688,P均 <0 .0 1) ,与A、IRT、ICT呈负相关 (r分别为 -0 .3 3 2 ,-0 .5 3 0 ,-0 .5 16,P <0 .0 1或 0 .0 5 )。结论　CGRP参与了肺动脉高压及右室功能减退的病理生理过程。

The relationship of the calcitonin gene-related peptide and the right ventricular function in patients with pulmonary hypertension

Objective To explore the relati on ship between the right ventricular function by echocardiography-derived indexes and the changes of concentrations of calcitonin gene-ralated peptide (CGRP) in p atients with pulmonary hypertension (PH). Methods The study group comprised 58 patients with PH(the PH group), 23 patients without PH (the non-PH group), and 20 subject s in the control group (the control group). The pulse-wave doppler echocardiogra phic spectrum of tricuspid valve and pulmonary artery were measured in the PH gr oup, the non-PH group and the control group, respectively. The plasma concentrat ions of CGRP were detected by radioimmunoassay. Results The comparison among the PH group and the non-PH group, the control group showed that the E, E/A decreased significant ly, A increased, PV lowered down significantly and IRT, ICT prolonged obviously and Tei indexes increased significantly in the PH group (all P<0.01). The pl asma concentrations of CGRP decreased significantly, and it had negative relationshi p with pulmonary artery systolic pressure (r=-0.735, P<0.01),and had positiv e relationship with E, E/A and PV (r=0.792, 0.762, 0.688, respectively, all P <0.01), and had negative relationship with A, IRT, ICT (r=-0.332, -0.530,-0.51 6, respectively,P<0.01 or 0.05). Conclusion CGRP were involved in the developin g of hypertension and the physiopathologic processes of the decrease of right ve ntricular function.