N-乙酰半胱氨酸对肺心病患者肺动脉压的影响及其机制探讨

N-乙酰半胱氨酸(N-acetylcyste ine,NAC)目前已广泛应用于慢性阻塞性肺病、肺心病的治疗,能有效缓解患者病情,但其对肺心病肺动脉压有何影响,以及通过何种机制起作用,至今未见文献报道。本研究拟观察NAC对肺心病肺动脉压的影响,并从保护肺血管内皮细胞、重建血管活性因子平衡的

Studies on effect of N - acetylcysteine on pulmonary hypertension in patients with pulmonary heart disease and its possible mechanism

Objective To investigate the effect of N-acetylcysteine(NAC) on pulmonary hypertension in patients with pulmonary heart disease(PHD) and its possible mechanism.Methods Patients with PHD were randomly assigned to receive standard therapy(standard therapy group) and standard therapy plus NAC group(NAC group).The ratio of right ventricular pre-ejection period to the pulmonary flow acceleration time(RVPEP/AT),an indicator of pulmonary hypertension,were measured in PHD patients before and after treatment.In addition,circulating endothelial cell count(CEC),plasma endothelin-1(ET-1) and nitric oxide(NO) levels were tested in healthy control group and PHD patients before and after treatment,respetively.Results Before treatment,CEC and plasma ET-1 levels were significantly higher,while plasma NO levels were significantly lower in PHD patients as compared with healthy control group(P<0.01).After treatment,RVPEP/AT,CEC and plasma ET-1 levels decreased and plasma NO levels increased significantly in the both therapy groups(P< 0.01 orP<0.05).But all these changes were greater in NAC group than in standard therapy group(P<0.01).Conclusion NAC is useful for relieving pulmonary hypertension in PHD patients.Protection of pulmonary vascular endothelial cell and reconstruction of balance of vasoactive factors may be the mechanism.