【摘要】 目的 :探讨内皮素 (ET)在慢性肺心病发病机制中的作用及其与肾素—血管紧张素—醛固酮系统(RAAS)及肾功能的关系。方法 :采用放免法测定 2 0例健康人、2 0例慢性肺心病急性发作期 (CPHD)及 2 0例慢阻肺缓解期 (COPD)患者血浆内皮素 (ET)、肾素活性 (PRA)、血管紧张素Ⅱ (AⅡ )、醛固酮 (ALDO)的水平 ,同时应用血气分析仪和生化检测技术测定PaO2 、PaCO2 、PH、CRE。结果 :CPHD组血浆ET、PRA、AⅡ、ALDO明显高于COPD组及正常组 (P <0 0 1) ,而COPD组与正常组间无显著性差异 (P >0 0 5 ) ;心功能Ⅲ～Ⅳ级组各项指标均高于心功能Ⅰ～Ⅱ级组 ;ET与PRA、AⅡ、CRE、PaCO2 呈正相关 ,与PH、PaO2 呈负相关。结论 :ET在肺心病肺动脉高压形成过程中起重要作用 ,与心衰、肾衰程度呈正比 ;ET与PRA、AⅡ相互协调、相互促进 ,共同参与肺心病心衰的病理过程。更多还原

【Abstract】 Objective:To invistigate the role of endothelin(ET) in the pathogenesis of chronic pulmonary heart disease(CPHD) and its relations with renal function as well as renin angiotensin aldosterone system(RAAS).Methods: Twenty persons with chronic pulmonary heart disease in acute stage(CPHD)and twenty persons with chronic obstructive pulmonary disease in remission stage(COPD) as well as twenty healthy persons as controls, whose level of plasma endothelin(ET),plasam renin activity(PRA),angiotensin Ⅱ(AⅡ),aldosterone(ALDO)were measured by using radioimmunization.Meanwhile,PaO 2,PaCO 2,PH,CRE were measured by using blood gas analyze instrument and technologies of biochemical analysis.Reuslt: Plasam ET,PRA,ALDO in group CPHD was significantly higher than group COPD and controls(P<0.01),Otherwise there was no significant difference between group COPD and controls(P>0.05).Group of heart function inⅢ～Ⅳ grade was higher than that in group Ⅰ～Ⅱ grade.ET had a positive correlation with PRA,AⅡ,CRE,PaCO 2 and negtive correlation with PH,PaO 2.Conclusions: ET play an important role in the prosses of pulmonary artery hypertension formation in pulmonary hear disease.ET was proportion to the degree of heart failure and renal failure.ET coordinated and prompted each other with PRA and AⅡ,and they participated together in the pathelogic prosses of heart failure in pulmonary heart disease.更多还原