摘要
目的 观察先天性心脏病合并肺动脉高压患者术前血浆血管紧张素的变化 ,探讨其在先天性心脏病合并肺动脉高压诊治中的意义。 方法 根据平均肺动脉压 /平均主动脉压 (MPAP/ MAP)的不同将 80例先天性心脏病患者分为 4组 ,每组 2 0例。对照组 :MPAP/ MAP<0 .2 5 ;轻度肺动脉高压组 (组 ) :MPAP/ MAP 0 .2 5～ 0 .45 ;中度肺动脉高压组 (组 ) :MPAP/ MAP0 .46～ 0 .75 ;重度肺动脉高压组 (组 ) :MPAP/ MAP>0 .75。采用放射免疫法测定术前血浆血管紧张素 浓度 ,测定患者术中血流动力学指标。 结果 组 和组 血管紧张素 均显著高于对照组 (P<0 .0 1) ;但组 中血管紧张素 与对照组比较无差异 (P>0 .0 5 )。 结论 血管紧张素 在先天性心脏病合并肺动脉高压的发病中可能起了一定的作用 ,围术期应用血管紧张素转换酶抑制剂以降低肺动脉压力 ,对提高该类患者的手术成功率有一定意义。
Objective\ To observe the change of plasma angiotensin Ⅱ in congenital heart disease patients with pulmonary hypertension before operation, and explore its role in the diagnosis and treatment of these patients.\ Methods\ According to the ratio of mean pulmonary artery pressure to mean aortic pressure, eighty patients were divided into four groups ( n=20 in each group). The ratio of the control group is smaller than 0.25; the ratio of the low grade pulmonary hypertension group(group Ⅰ) was between 0.25 and 0.45; the ratio of the moderate pulmonary hypertension group(group Ⅱ) was between 0.46 and 0.75; the ratio of the severe pulmonary hypertension group(group Ⅲ) was larger than 0.75. The plasma concentration of angiotensin Ⅱ was measured with radioimmunity assay before operation and the hemodynamics index was measured during operation.\ Results\ The plasma angiotensin Ⅱ of the group Ⅰ and group Ⅱ were all significantly higher than that of the control group( P<0 01) . But the difference of plasma angiotensin Ⅱ between the group Ⅲ and the control group was insignificant ( P>0 05) .\ Conclusion\ Angiotensin Ⅱ might play some role in the pathogenesis of congenital heart diseases with pulmonary hypertension. Therefore, the using of angiotensin converting enzyme inhibitors might be of some significance to improve the operative results in these patients.
出处
《中国胸心血管外科临床杂志》
CAS
2000年第2期80-83,共4页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
先天性心脏病
肺动脉高压
血管紧张素Ⅱ
Congenital heart disease Pulmonary hypertension Angiotensin Ⅱ
