先天性心脏病合并肺动脉高压患者尾加压素Ⅱ、 降钙素基因相关肽.docVIP

先天性心脏病合并肺动脉高压患者尾加压素Ⅱ、 降钙素基因相关肽 　【摘要】 目的 观察先天性心脏病（CHD）合并肺动脉高压（PH）患者手术前后尾加压素Ⅱ（UⅡ）、降钙素基因相关肽（CGRP）和内皮素（ET）的变化。方法 将42例先天性心脏病患者按其肺动脉收缩压分为无PH组，轻度PH组，中度PH组，重度PH组。采用放射免疫法测定各组术前术后UⅡ、CGRP和ET含量，分析其与肺动脉压力（PAP）的关系。结果 ①术前UⅡ含量各组间差异无显著性，UⅡ与PAP无关；CGRP含量随着PAP增高而减低；ET含量随着PAP增高而增高。②术后各组UⅡ与术前无明显改变；各组CGRP含量增高，与术前相比差异显著；各组ET含量降低，与术前相比差异显著。结论 UⅡ含量与PAP程度无明显相关；CGRP和ET在PH形成和血管重建中发挥重要作用，可作为衡量肺高压程度和性质的重要指标。 【关键词】 先天性心脏病 肺高压 尾加压素 降钙素基因相关肽 内皮素 Abstract: OBJECTIVE To explore the changes and significance of pre-and post-operative urotensinⅡ(UⅡ), calcitonin gene related peptide(CGRP) and endothelin(ET) in patients with congenital heart disease(CHD) complicated whth pulmonary hypertension(PH). METHODS 42 CDH patients with left-to-right shunt were divided into four groups according to pulmonary artery systolic pressure(PASP):group A was not pulmonary hypertension，group B was mild pulmonary hypertension，group C was moderate pulmonary hypertension，group D was concentration pulmonary hypertension，UⅡ, CGRP and ET levels of each group were examined by radioimmunoassay method. The relationship of UⅡ,CGRP,ET and pulmonary artery pressure(PAD) was analysed . RESULTS ① The plasma levels of UⅡin each group before operation were no obvious differences, therefore no correlation between plasma level of UⅡ and PAP was found，the levels of CGRP reduced with the increased PAP, the levels of ET significantly higher with the increased PAP .② After operation, the levels of UⅡin each group had no differences,the levels of CGRP increased significantly，while the levels of ET decreased singnificantly. CONCLUSION There is no correlation between PAP and significantly of UⅡ, CGRP and ET may play an important role in the pathogenesis of PH and restructuring of vasculature and can be the major indexes for judging the degree and nature of PH. Key words： Congenital heart disease； Pulmonary hypertension；Significance of urotensinⅡ； Calcitonin gene related peptide; Endothelin 肺动脉高压（PH）是左向右分流型先天性心脏病（CHD）最常见的严重并发症之一，其严重程度直接影响手术疗效和预后，