摘要
目的 探讨先天性心脏病肺动脉高压 (PH)病人肺组织一氧化氮合酶 (NOS)、内皮素(ET)的mRNA表达改变及其临床意义。方法 治疗组 2 1例先心病患者 ,平均肺动脉压为 5 8±2 1mmHg ,肺血管阻力 760± 2 0 6dyn .s.cm-5。于开胸后立即取肺组织采用RT PCR技术检测NOS、ET及其相关基因表达的变化。结果 PH组肺组织结构型NOS(cNOS)及诱导型NOS(iNOS)mRNA表达均减少 ,以cNOSmRNA为明显 ;cNOSmRNA ,iNOSmRNA电泳光密度均较对照组为低。肺组织ET 1及ETARmRNA的表达明显较对照组为高 ,而ETBRmRNA的表达则低于对照组。分析表明 ,PH程度越重 ,其cNOSmRNA的表达减少越明显 ,而ET及其受体的mRNA表达则呈现相反的改变。结论 先心病PH患儿肺组织血管活性因子发生明显改变 ,提示此类患儿宜尽早手术纠治 ,以从根本上消除形成PH的条件。
Objective To elucidate further the pathophysiological changes of vasoactive factors of congenital heart disease(CHD) with pulmonary hypertension(PH).Methods Twthods Twenty one patients with CHD plus PH underwent cardiovascular surgery from Nov.1997 to Feb.1999,of whom mPAP was 58±21 mmHg and mPVP was 760±206dyn.s.cm -5 .The PH was severe in 14 cases but medium in 7.All patients underwent cardiac surgery under CPB except for PDA of four cases which was ligated without CPB.One patient died immediately postoperatively.The pulmonary tissue was removed immediately after the chest was opened up.Nitric oxide synthase (NOS),endothelin(ET) and their relative gene of pulmonary tissue of PH were examined respectively.Results There were stronger hybridization signals of endothelin mRNA and endothelin receptor mRNA in PH than in control group.The results further confirmed that the small pulmonary arteries,especially those whose diameter was less than 100μm,had more intense hybridization signals.The RT PCR results demonstrated that cNOS and iNOS mRNA expression decreased,but the former was more remarkable.Meanwhile,ET 1 mRNA and ETAR mRNA expression was higher in PH group than in control group,but ETBR mRNA expression was lower in PH group than in control group.There were negative correlations between cNOSmRNA expression and level of pulmonary arterial pressure in the patients with CHD and PH,but there were positive correlations in endothelin 1 value.Conclusion The vasoactive factor of pulmonary tissue might change remarkably in the patients with congenital heart disease and pulmonary hypertension.In order to eliminate the development of PH,we suggest that early surgical treatment be desirable for the patients.
出处
《江苏医药》
CAS
CSCD
北大核心
2001年第8期567-569,共3页
Jiangsu Medical Journal
基金
江苏省青年基金(BQ980 0 5 )
江苏省卫生厅科研基金 (H9741)资助
