摘要
目的 探讨肾上腺髓质素 (ADM)及其受体 (ADMR)在慢性阻塞性肺疾病 (COPD)的表达水平 ,并研究其在COPD中可能的作用与机制。方法 本组研究调查了两批患者 ,第一批患者均为肺叶切除患者 ,共 16例 ,分为COPD组 (Ⅰ组 ) 9例和对照组 (Ⅱ组 ) 7例 ,对这两组患者用形态计量学方法检测了肺血管形态 ,用组织原位杂交测定ADM与ADMRmRNA的表达 ;第二批患者均为未做切除术的COPD患者 2 2例 ,根据平均肺动脉压 (mPAP)的不同分为COPD不伴肺动脉高压组 (A组 )10例和COPD伴肺动脉高压组 (B组 ) 12例 ,用右心漂浮导管法检测A、B两组血流动力学、放射免疫法测定肺动脉血ADM水平 ,同时检测动脉血气。结果 (1)肺叶切除的患者 :①Ⅰ组肺小动脉管壁厚度与血管外径比值及管壁面积与血管面积比值显著高于Ⅱ组 (P <0 0 1) ,②原位杂交发现Ⅰ、Ⅱ组肺小动脉壁ADMmRNA与ADMRmRNA表达比较差异有显著性 (P <0 0 5 ) ;(2 )未作切除术的患者 :A、B两组COPD患者肺动脉血ADM水平比较差异有显著性 (P <0 0 5 ) ;并与mPAP、肺血管阻力(PVR)呈正相关 (r分别 =- 0 4 1、0 5 2 ,P均 <0 0 5 ) ,与动脉血氧分压 (PaO2 )呈负相关 (r =0 4 1,P <0 0 5 )。结论 ADM可能作为局部自分泌 /旁分泌因子在COPD的发展与肺动脉高压形成中发挥?
Objective To investigate the expression and role of adrenomedullin(ADM) and adrenomedullin receptor(ADMR) in patients with chronic obstructive pulmonary disease(COPD).Methods The first study included9 COPD patients(groupⅠ) and 7 control patients(groupⅡ) who had underwent pulmonary lobe resection. Small pulmonary artery remodeling was observed with morphometric analysis. The expressions of ADM and ADMR mRNA in lung tissue were examined by hybridization in situ. The second study recruited 22 patients with COPD. Cardiac catheterization was performed to monitor the changes of hemodynamic parameters and the subjects were divided into two groups according to the mean pulmonary artery pressure(mPAP):patients without pulmonary hypertension(PH,group A, n=10) and patients with PH(group B, n=12). The levels of pulmonary arterial plasma ADM were measured by radioimmunoassay. Arterial blood gas was also measured. Results (1) In patients underwent pulmonary lobe resection:① Morphometry studies showed that the ratio of vascular wall thickness to external diameter (MT%) and ratio of vascular wall area to total area (MA%) increased in group Ⅰ( P<0.01);②Hybridization in situ showed that ADM/ADMR mRNA expressions were significantly higher in pulmonary artery walls of groupⅠ as compared with groupⅡ( P<0.01). (2) In COPD patients without pulmonary lobe resection,the plasma ADM level of group B was significantly higher than that of group A ( P<0.05),and the plasma ADM level had a significantly positive correlation with mPAP and pulmonary vascular resistance(PVR),but a negative correlation with PaO 2. Conclusion ADM may play an important protective role as a local autocrine/paracrine factor in the development of COPD and PH.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2003年第12期765-768,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
基金
国家自然科学基金资助项目 ( 3 0 2 70 5 81)
湖南省自然科学基金资助项目 ( 99JJY0 0 3 3 )
湖南省教育厅优秀青年基金资助项目 ( 0 0B0 0 4)
