【摘要】 目的 :探讨内皮素 - 1(endothelin- 1,ET- 1)在慢性缺氧性肺动脉高压发生中的作用及白花前胡提取物(QF- 8)降低肺动脉高压作用机制。方法 :分别用右心漂浮导管法和放射免疫法同步检测 11例慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)继发性肺动脉高压患者口服 QF- 8前、后血流动力学指标和体静脉、肺动脉及体动脉血浆 ET- 1水平。结果 :COPD患者体静脉 ET- 1水平显著高于正常对照组体静脉 (P <0 .0 1)、自身肺动脉 (P <0 .0 5 )及自身体动脉 (P <0 .0 1)血浆 ET- 1水平 ,且血浆 (包括体静脉、肺动脉及体动脉 ) ET- 1水平均与 Pa O2 呈显著负相关 ,与肺血管阻力指数 (pulmonary vascular resistance index,PVRI)呈显著正相关。口服QF- 8后 ,肺动脉压力和 PVRI明显下降 ,同时血浆 ET- 1水平亦呈不同程度下降 ,其下降幅度依次为体静脉(2 5 % ) >肺动脉 (2 1% ) >体动脉 (10 % ) ,与血浆 ET- 1水平升高顺序一致。结论 :ET- 1的合成或分泌功能异常可能参与了慢性缺氧性肺动脉高压的形成 ,QF- 8降低肺动脉高压作用与抑制 ET- 1合成或分泌的某些环节有关更多还原

【Abstract】 Objective: Our aim was to study the effect of endothelin 1 (ET 1) on the development of chronic hypoxic pulmonary hypertension and mechanism of QF 8 (the extract of baihua qianhu, a Chinese traditional medicine) in lowering pulmonary hypertension. Methods: The indexes of hemodynamics and the levels of plasma ET 1 in systemic vein, pulmonary artery, and systemic artery in 11 patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease (COPD) were measured with right heart catheterization and radioimmunoassay. Results: The ET 1 level in patients was significantly higher in systemic vein than that in 15 controls (P<0.01), pulmonary artery (P<0.05), and systemic artery (P<0.01). The levels of plasma ET 1 in patients had significant negative correlation with PaO 2 and positive correlation with pulmonary vascular resistance index (PVRI). After taking QF 8, mean pulmonary artery pressure (mPAP) and PVRI significantly decreased, meanwhile, the levels of plasma ET 1 in systemic vein, pulmonary artery, and systemic artery also decreased by 25%, 21%, and 10%, respectively. Conclusion: Abnormality in synthesis or secretion of ET 1 may play a role in the development of chronic hypoxic pulmonary hypertension. The effect of QF 8 on pulmonary hypertension in patients with COPD may be related with its inhibition on the synthesis or secretion of ET 1.更多还原