前列腺素E1及卡托普利对先心病肺动脉高压患儿血浆ET-1水平的影响

摘要

为探讨前列腺素E1（PGE1）和卡托普利对先心病（CHD）患儿血浆内皮素（ET-1）水平的影响，将33例左向右分流伴肺动脉高压（肺高压）的CHD患儿随机分为两组，观察Ⅰ组（16例）给予PGE120ng／（kg.min）静脉滴注；观察Ⅱ组（17例）给予卡托普利1mg／（kg.d）口服，均用药15天。用放免法测定两组用药前后静脉血浆ET-1含量，并与健康儿童（对照组）进行比较。结果观察组用药前血浆ET-1水平均较对照组明显升高（P＜0.001）；用药后观察Ⅰ组血浆ET-1水平及平均肺动脉压均明显低于观察Ⅱ组（P＜0.05）；观察Ⅱ组用药后平均肺动脉压和血浆ET-1水平有下降趋势，但与用药前比较无统计学差异（P＞0.05）。因此认为，ET-1效应拮抗剂PGE1对延缓CHD患儿肺高压形成和发展具有重要意义。%In order to study the influence of prostglandin E1 and captoprilon plasma endothelin-1 levels in children with congenital heart defects（CHD）.Divided 33 CHD children into two groups randomly.Then gave them intravenous PGE1（PGE1 group） 20ng／（kg.min），or oral captopril（captopril group）1mg／（kg.d）for 15 days，and their femoral venous blood were accumulated（about 2ml）before and after the drug therapy，the plasma endothelin-1 concentrations were measured.Result showed that the plasma endothelin-1 concentrations were significantly higher in children with pulmonary hypertension than those normal subjects，and prostglandin E1 could significantly decrease the patients’ mean pulmonary hypertension and their plasma endothelin-1 levels，while captopril showed the trend to decrease the patients’ mean pulmonary hypertension and their plasma endothelin-1 levels，however it couldn’t reach the statistic levels.This suggests that the endothelin-1 antagonist may delay the development of pulmonary hypertension in children with CHD