先天性心脏病合并肺动脉高压新生儿血ET-1、NO水平变化的研究

摘要

Objective:To find out the relationship between plasma endothelin-1 (ET-1) and serum nitric oxide (NO)level changes and pulmonary arterial pressure in neonates with congenital heart disease (CHD).Methods :Thirty healthy newborns were randomly recruited as control subjects( group A ), and 70 newborns with CHD were allocated to three groups, i.e. CHD without pulmonary hypertension (PH) (group B, n =30), CHD with mild PH(group C, n =20) and CHD with moderate to severe PH(group D, n =20). Radioimmunoassay was used to detect the concentration of plasma ET-1 and the level of serum NO-2/NO-3 was measured with nitrate reduetase. Results :①Plasma ET-1 concentration in newborns with CHD was significantly higher, yet serum NO level was lower as compared with the controls(P ＜0. 01 ). ②Plasma ET-1 concentration in group C and D was significantly higher than that in group A and B (P ＜ 0.01 ), with the same results concerning serum NO level( P ＜0. 01 ). ③ET-1 concentration was positively related to pulmonary arterial pressure( r =0. 729 ,P ＜0. 01 ), whereas serum NO was negatively related to the level of pulmonary arterial pressure ( r = - 0. 282, P ＜ 0.05 ),and plasma ET-1 was also negatively associated with serum NO ( r = -0. 917 ,P ＜0. 01 ). Conclusion:Elevated plasma ET-1 but reduced NO level were observed in newborns with CHD, suggesting that the two factots are involved in the pathogenesis of PH.%目的:探讨先天性心脏病新生儿血浆ET-1、血清NO浓度的变化以及与肺动脉压力间的关系.方法:选择健康新生儿30例为对照组,30例无肺动脉高压的CHD新生儿为无PH组,20例CHD合并轻度肺动脉高压患儿为轻度PH组.20例CHD合并中重度肺动脉高压新生儿为中重度PH组.采用放射免疫法测定血浆ET-1浓度、硝酸还原酶法测定血清NO-2/NO-3浓度.结果:①先天性心脏病患儿血浆ET-1水平明显高于对照组(P<0.01);血清NO浓度低于对照组(P<0.01).②轻度、中重度PH组血浆ET-1水平明显高于无PH组及对照组(P<0.01);血清NO浓度,轻度、中重度PH组明显低于无PH组及对照组(P<0.01).③血浆ET-1水平与肺动脉压力呈正相关(r=0.729,P<0.01),血清NO水平与肺动脉压力呈负相关(r=-0.282,P<0.05);血清NO与血浆ET-1水平呈显著负相关(r=-0.917,P<0.01).结论:新生儿先天性心脏病患儿ET-1水平升高、NO水平降低且两者参与肺动脉高压的形成.