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目的探讨血清碱性成纤维细胞生长因子(bFGF)在低氧性肺动脉高压发病中的作用。方法采用双抗体夹心酶联免疫吸附法(ELISA)检测高原地区(海拔2260~3300m)38例慢性肺源性心脏病(肺心病)急性加重期患者、30例慢性阻塞性肺疾病(COPD)缓解期患者和30例当地健康人血清bFGF含量,并使用彩色多普勒超声心动仪测定肺动脉血流频谱,计算平均肺动脉压(MPAP),使用血气分析仪测定动脉血氧分压(PaO2)。结果肺心病组血清bFGF(87.54±12.15)ng/L、MPAP(45.86±5.63)mmHg(1mmHg=0.133kPa)显著高于COPD组分别为(55.72±9.08)ng/L和(22.95±2.56)mmHg,P均<0.01,COPD组显著高于健康对照组分别为(49.83±8.78)ng/L和(20.34±2.23)mmHg,P均<0.05;肺心病组PaO2(38.79±4.56)mmHg显著低于COPD组(58.22±6.18)mmHg,P<0.01,COPD组则显著低于健康对照组(66.57±5.48)mmHg,P<0.01。肺心病组和COPD组血清bFGF水平与MPAP均呈显著正相关(r肺心病=0.788,rCOPD=0.674,P均<0.01),与PaO2均呈显著负相关(r肺心病=-0.735,rCOPD=-0.587,P均<0.01)。结论慢性肺心病患者血清bFGF水平明显升高,可能与其慢性低氧性肺动脉高压形成有一定关系。
Objective To investigate the role of serum basic fibroblast growth factor (bFGF) in the pathogenesis of hypoxic pulmonary hypertension. Methods Thirty-eight patients with acute exacerbation of chronic cor pulmonale (pulmonary heart disease) in the plateau region (2260 ~ 3300 m altitude) and 30 patients with chronic obstructive pulmonary disease (COPD) were examined by ELISA. And the serum levels of bFGF in 30 healthy volunteers. The pulmonary artery blood flow spectrum was measured by color Doppler echocardiography. The mean pulmonary arterial pressure (MPAP) was calculated. PaO2 was measured by gas analyzer. Results The serum level of bFGF (87.54 ± 12.15) ng / L and MPAP (45.86 ± 5.63) mmHg (1mmHg = 0.133 kPa) in patients with pulmonary heart disease were significantly higher than those in COPD patients (55.72 ± 9.08 ng / L and 22.95 ± 2.56 mmHg, respectively , P <0.01, the COPD group was significantly higher than that of the healthy control group (49.83 ± 8.78) ng / L and (20.34 ± 2.23) mmHg, P <0.05 respectively; PaO2 (38.79 ± 4.56) mmHg in the pulmonary heart disease group was significantly lower than COPD group (58.22 ± 6.18) mmHg, P <0.01, COPD group was significantly lower than the healthy control group (66.57 ± 5.48) mmHg, P <0.01. There was a significant positive correlation between bFGF level and MPAP in cor pulmonale group and COPD group (r Coronary heart disease = 0.788, rCOPD = 0.674, P <0.01), and negative correlation with PaO2 (r Coronary heart disease = -0.735, rCOPD = -0.587, P <0.01). Conclusion Serum bFGF levels in patients with chronic cor pulmonale are significantly increased, which may be related to the formation of chronic hypoxic pulmonary hypertension.