论文部分内容阅读
目的探讨尾加压素Ⅱ(UⅡ)及内皮素(ET)在小儿先天性心脏病(CHD)合并肺动脉高压(PH)患者手术前后的变化以及临床意义,研究肺动脉高压的产生机制。方法61例患者按肺动脉收缩压分为3组。测定3组术前、术后即刻、术后3、7 d的AngⅡ及UⅡ含量,并比较手术前后的变化;分析两者与肺动脉压(PAP)间的相互关系。结果3组患者不同时期肺动脉压(PAP)与血浆ET浓度均呈正相关。3组患者UⅡ浓度则与PAP无相关性。术后即刻ET浓度都降低,但是差异无统计学意义(P>0.05),各组术后ET浓度均呈下降趋势,术后7 d和术前相比差异均有统计学意义(P<0.01)。3组患者手术前后UⅡ浓度差异无统计学意义(P>0.05)。结论ET在PH形成和血管重建中发挥重要的作用,血浆ET水平可作为判断PH严重程度的指标之一。UⅡ与PAP无相关性,但不能排除UⅡ在PH形成和血管重建中有重要的作用。
Objective To investigate the changes and clinical significance of urotensin Ⅱ (UⅡ) and endothelin (ET) before and after surgery in children with congenital heart disease (CHD) complicated with pulmonary hypertension (PH) and to study the mechanism of pulmonary hypertension. Methods 61 patients were divided into three groups according to pulmonary artery systolic pressure. The contents of AngⅡ and UⅡ in preoperative, postoperative, postoperative and postoperative 3 and 7 days were measured and the changes of preoperative and postoperative changes were compared. The relationship between them and pulmonary artery pressure (PAP) was analyzed. Results Pulmonary arterial pressure (PAP) and plasma ET concentration were positively correlated in all three groups. UⅡ concentration in the three groups had no correlation with PAP. Postoperative ET concentrations were reduced, but the difference was not statistically significant (P> 0.05), ET concentrations in all groups showed a downward trend, postoperative 7d and preoperative differences were statistically significant (P <0.01 ). There was no significant difference in UⅡconcentration between the three groups before and after operation (P> 0.05). Conclusions ET plays an important role in the formation of PH and vascular remodeling. The level of ET in plasma can be used as one of the indicators to judge the severity of PH. There is no correlation between UII and PAP, but UII can not be ruled out that UII plays an important role in PH formation and vascular remodeling.