肺血栓栓塞患者血浆ET-1、NO水平与血管内皮依赖性舒张功能的关系

目的探讨肺血栓栓塞症（PTE）患者溶栓和（或）抗凝治疗前后血浆内皮素1（ET-1）、一氧化氮（NO）及血管内皮依赖性舒张功能（EDD）的变化及其临床意义。方法PTE患者82例,分为溶栓组及抗凝组,并选取健康者20例为对照组。应用放射免疫方法检测ET-1,硝酸还原酶法测定血浆NO浓度,同时应用超声测量肱动脉EDD,并比较溶栓和抗凝治疗前及治疗1周时各项指标的变化。结果与对照组相比,溶栓及抗凝治疗组NO、ET-1、EDD差异有统计学意义（P均〈0.01）。两组PTE患者治疗1周后NO、EDD较治疗前明显升高、ET-1明显下降,差异亦有统计学意义（P均〈0.01）。相关分析显示,PTE患者ET与NO、EDD呈负相关（r=-0.508、-0.533,P均〈0.01）;NO与EDD呈正相关（r=0.685,P〈0.01）。结论肺栓塞患者存在血管内皮功能损伤,EDD可以作为评价肺栓塞患者内皮功能损伤的指标。

Relationship between endothelial dependent dilatation and plasma levels of endothelin-1, nitric oxide in patients with pulmonary thromboembolism

Objective To study the changes and clinical significance of the endothelial dependent dilatation（EDD）and endothelin（ET-1）,nitric oxide（NO） levels in plasma of patients with pulmonary thromboembolism（PTE） before and after thrombolysis and anticoagulation.Methods 82 PTE patients were divided into two treatment groups（thrombolysis group and anticoagulation group）,while 20 persons in which PTE was excluded were served as the control group.ET-1 was detected by radio-immunity method,NO was detected by nitrate reductase methodand and EDD was measured by ultrasound, and the changes of these parameters were compared befor treatment and 1 week posttreatment. Results Compared with control group, there were obviously statistical difference in NO,ET-1 ,EDD levels in thrombolysis group and anticoagulation group（ all P 〈 0.01 ）. After therapy for one week ,the level of ET-1 was significantly lower than that before therapy （ P 〈 0.01 ） , but NO and EDD were significantly higher than those before therapy （ P 〈 0.01 ）. ET were negatively correlated with NO and EDD in PTE patients （ r = - 0.508, - 0. 533, all P 〈 0.01 ） , NO had the positive correlation with EDD （ r = 0. 685 ,P 〈 0.01 ）. Conclusions Endothelium fuction damage is detected in patients with PTE, EDD may open up a new convenient path to detect vascellum endothelium impairment in patients with pulmonary thromboembolism.