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充血性心力衰竭患者血浆一氧化氮和内皮素等的改变 |
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侯凡 祝善俊 李隆贵 徐有奇 潘婕
【摘要】 目的 探讨充血性心力衰竭时血浆一氧化氮（NO）、内皮素（ET）的变化及前列腺素的影响。方法 测定35例充血性心力衰竭（心衰）患者血浆NOET血管紧张素转换酶（ACE）活性。20例健康者作对照组。15例患者静脉滴注前列腺素E1(PGE1,20～40 ng.kg-1.min-1)，Swanganz导管监测血流动力学，用药前后测肺动脉、头静脉血浆NO、ET和ACE活性。结果 心衰患者存在肺动脉高压，心衰组血浆NO高于对照组，肺动脉血浆中高于自身静脉。心衰组血浆ET和ACE活性呈相似改变。心衰组血浆ET的增幅大于NO，NO/ET比值下降。上述改变均与心衰严重程度有关（P<0.05）。前列腺素E1显著降低肺动脉压力，增加心脏指数，降低血浆NO、ET和ACE水平，增加NO/ET比值。结论 血浆NO水平增高是心力衰竭病理生理特征之一。NO、ET与NO/ET等改变与肺动脉高压和局部血管内皮细胞损伤有关，参与心衰的病理生理。前列腺素E1可以抑制上述改变。
【关键词】 一氧化氮 内皮缩血管肽类 心力衰竭，充血性
The effects of nitric oxide and endothelia levels on plasma in patients with chronic heart failure HOU Fan*, ZHU Shanjun, LI Longgui, et al. *Department of Candiology, The 452th Hospital of PLA, Chengdu 610061
【Abstract】 Objective To study the effects of postaglandin E1 on plasma nitric oxide (NO) and endothelin (ET) levels in patients with chronic heart failure. Methods Pulmonary artery pressare (PAP), pulmonary arterial and venous plasma ET and angiotensin converting enzyme (ACE) levels were determined in patients with chronic heart failure (CHF) and the effects of prostaglandin E1 (PGE1) were evaluated.Results (1) Pulmonary hypertension was present in patients with CHF. Plasma NO and ET levels in the pulmonary artery were higher than those in the pulmony vein (P<0.05),the levels in the latter was in turn higher than those in normal subjects (P<0.05). (2) Plasma ACE levels showed a similar change, (3) The increase of plasma ET was more than the increase of NO in patients with CHF, thus, NO/ET ratio was decreased in CHF (P<0.05). (4) PGE1 caused significant decrease in PAP but increase in cardial index. It decreased plasma NO, ET, ACE, and increased NO/ET ratio (P<0.05). These effects became more apparent with the increase of PGE1 level. Conclusion NO and NO/ET ratio might be involved in CHF by causing pulmonary hypertension and local vascular endthalium perturbation. PGE1 could inhibit these effects and play an important[1] [2] 下一页
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