目的 探讨先天性心脏病(CHD)合并肺动脉高压(PH)患儿手术前后硫化氢(H2S)及血红素氧合酶-1(HO-1)变化的临床意义.方法 将48例CHD患儿按肺动脉收缩压(PASP)分为三组:无PH组(PASP ＜ 30 mmHg＝15例,轻度PH组(PASP 30 ～ 49 mmHg)15例,中、重度PH组(PASP ≥ 50 mmHg)18例.测定三组手术前、手术后1 h及手术后24 h血浆H2S及血清HO-1含量,并比较手术前后的变化;分析两者与PASP间的相互关系.结果 各组患儿术后H2S含量呈上升趋势,但只有术后24 h与术前比较差异有统计学意义(P ＜ 0.05).三组患儿手术前后HO-1活性差异无统计学意义(P ＞ 0.05).三组患儿H2S含量与PASP呈负相关(r ＝ -0.730 ～ -0.458,P均＜ 0.01).三组患儿HO-1活性与PASP无相关性(术前r ＝ -0.031 ～ 0.230,P均＞ 0.05).结论 H2S在PH形成和肺血管重建中发挥重要作用.%Objective To evaluate the clinical significance of hydrogen sulfide (H2S) and heme oxgenase-1 (HO-1) in pulmonary hypertensin (PH) in congenital heart disease (CHD) patients with pulmonary hypertension (PH). Methods According to pulmonary artery systolic pressure (PASP) , 48 (llD patients were divided into three groups, no PH group (PASP ＜ 30 mmHg, n= 15), mild PH group (PASP 30 ～ 49 mmHg, n= 15), and serve PH group (PASP ≥ 50 mmHg, n= 18). The levels of plasma H2S and serum HO-1 were detected and compared at preoperation, an hour and 24 hours post-operation The correlations between plasma H2S, serum HO-1 and PASP were analyzed.Results The level of plasma H2S in each group after operation was higher than that of the same group before operation.The level of plasma H2S was significantly higher 24 hours post-operation than that at pre-operation in the same group (P ＜ 0.05) The activity of HO-1 was not significantly different among three groups at any time point (P ＞ 0.05). The level of plasma H2S was negatively correlated with PASP in each group at pre-operation (r= -0.660, P ＜ 0.01) , an hour post-operation (r= -0.458, P ＜ 0.01) , and 24 hours post-operation (r= -0.730, P ＜ 0.01). The activity of HO-1 was not correlated with PASP in each groups at pre-operation (r= 0.230, P ＞ 0.05), an hour post-operation (r =0.072, P ＞ 0.05), and 24 hours post-operation (r= -0.131, P ＞ 0.05). Conclusions It is suggested thai H2S plays an important role in the formation of PH and restructure. The level of plasma H2S may be a reliable biomarker to evaluate the severity of PH.
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