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测定３３例二尖瓣狭窄患者二尖瓣球囊成形术（ＰＴＭＶ）前后血浆Ｐ物质水平的变化，研究血浆Ｐ物质与心房压的关系和评价Ｐ物质在充血性心力衰竭的病理生理意义。结果发现这些患者肘静脉的基础血浆Ｐ物质水平明显高于３１例健康对照组（３１．７３±４．９７与２６．０３±５．０３ｐｇ／ｍｌ，Ｐ＜０．００１）１８例心功能Ⅱ级（２９．５６±５．０６ｐｇ／ｍｌ）和１５例心功能Ⅲ级（３４．３３±３．４８ｐｇ／ｍｌ）的患者血浆Ｐ物质水平显著高于正常对照组（分别Ｐ＜０．０５和Ｐ＜０．００１）；心功能Ⅱ级与Ⅲ级间比较也有显著差异（Ｐ＜０．００５）。ＰＴＭＶ后１０～１５ｍｉｎ，股静脉的血浆Ｐ物质水平从术前的３２．４５±５．２４降到２８．２４±６．６５ｐｇ／ｍｌ（Ｐ＜０．０１）：术后７２ｈ，肘静脉的血浆Ｐ物质水平已降到２６．１２±４．６５ｐｇ／ｍｌ（与术前比较Ｐ＜０．００１；与对照组比较Ｐ＞０．５０）。术前及术后１０～１５ｍｉｎ股静脉的血浆Ｐ物质水平与同步测得的平均左房压（ｒ＝０．４１２，Ｐ＜０．００１）和平均右房压（ｒ＝０．０４３，Ｐ＜０．００１）呈显著正相关；术前及术后７２ｈ肘静脉的血浆Ｐ物质水平与同步测得的平均二尖瓣跨瓣压差（ｒ＝０．４２?
The changes of plasma substance P levels in patients with mitral stenosis before and after mitral valve balloon angioplasty (PTMV) were measured. The relationship between substance P and atrial pressure and the pathophysiological significance of substance P in congestive heart failure were studied. The results showed that basal plasma P level in the cubital vein of these patients was significantly higher than that in 31 healthy controls (31.73 ± 4.97 vs 26.03 ± 5.03 pg / ml, P <0.001) The levels of plasma substance P in patients with grade (29.56 ± 5.06pg / ml) and 15 patients with grade Ⅲ (34.33 ± 3.48pg / ml) were significantly higher than those in normal controls (P <0.05 and P <0.001). There was also significant difference between grade Ⅱ and Ⅲ in cardiac function (P <0.005). The level of plasma substance P decreased from 32.45 ± 5.24 to 28.24 ± 6.65pg / ml preoperatively (P <0.01) 10 to 15 minutes after PTMV. At 72 hours after operation, Plasma P levels dropped to 26.12 ± 4.65 pg / ml (P <0.001 compared with preoperative; P> 0.50 compared with controls). Preoperative and postoperative 10 ~ 15min femoral vein plasma P levels and measured mean left atrial pressure (r = 0.412, P <0.001) and mean right atrial pressure (r = 0.043, P <0.001). The plasma P level in the elbow vein at 72h before operation and after operation were significantly correlated with the mean mitral valve pressure (r = 0.42?