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检测了左向右分流型先天性心脏病51例患儿血浆免疫活性心房利钠多肽(ir-ANP)、环磷酸乌苷(cGMP)、血管紧张素Ⅱ(ATⅡ)水平及肾素(PRA)和血管紧张素转化酶(ACE)活性。结果显示,先天性心脏病组血浆ir-ANP、cGMP、ATⅡ,ACE较对照组明显增高(P<0.01),PRA则无显著差异(P>0.05)。血浆ir-ANP,ATⅡ水平还与心脏缺损直径大小以及平均肺动脉压力正相关(P<0.05)。结果提示,左向右分流型先天性心脏病时ACE活性增加,血浆ATⅡ水平因而升高,促进肺动脉高压。ANP代偿性分泌增多则阻抑ATⅡ效应。
The levels of plasma immunoreactive atrial natriuretic peptide (ir-ANP), cGMP, ATⅡ and PRA in children with left-right shunt congenital heart disease (CHD) And angiotensin-converting enzyme (ACE) activity. The results showed that the levels of plasma ir-ANP, cGMP, ATⅡ and ACE in congenital heart disease group were significantly higher than those in control group (P <0.01), but there was no significant difference in PRA (P> 0.05). Plasma levels of ir-ANP and ATⅡ were also positively correlated with heart defect diameter and mean pulmonary artery pressure (P <0.05). The results suggest that ACE activity is increased in left-to-right shunt congenital heart disease, thereby increasing plasma AT II levels and promoting pulmonary hypertension. ANP compensatory secretion increased inhibition of AT Ⅱ effect.