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JAHA:先天性心脏病合并肺动脉高压患者的肺功能、炎症及内皮素1水平分析!

2018-02-14 xing.T MedSci原创

由此可见,CHD-APAH患者炎症生物标志物水平升高。呼吸道生理的显著异常可能导致呼吸困难,但不受循环和痰液细胞因子的影响。增加的血清内皮素-1和气道功能障碍之间的关系可能与支气管收缩性能相关。

气喘是先天性心脏病合并肺动脉高压 (CHD-APAH)患者最常见的症状,以前认为是由PAH恶化引起的,但也可能是由炎症和肺功能异常所致。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员分析了CHD-APAH患者肺功能和气道炎症,并与对照者结果进行比较。

六十例患者纳入研究:20例CHD-APAH患者、20例CHD对照者和20例健康对照者。研究人员评估了受试者肺功能、气体交换、全身体积描记法和肺清除指数、6分钟步行距离和医学研究理事会进行的呼吸困难评分。研究人员测定了受试者血液和诱导痰液中的炎症标志物和内皮素1水平。

CHD-APAH患者存在限制性肺功能异常、气道阻塞和通气性不一致。CHD-APAH患者医学研究理事会进行的呼吸困难评分与预测峰值呼气流速百分比(r=-0.5383,P=0.0174),1s用力肺活量预测百分比占用力肺活量50%(r=-0.5316,P=0.0192)以及1秒用力呼气量的预测百分比(r=-0.6662,P=0.0018)和用力肺活量预测百分比(r=-0.5536,P=0.0186)之间呈负相关性。CHD-APAH患者气喘更常见,6分钟步行距离越低(360米 vs. 558米 vs. 622米,P=0.00001)。相比于对照者,CHD-APAH患者内皮素-1、白细胞介素(IL)-1β、IL-6、IL-8、肿瘤坏死因子α和血管内皮生长因子水平较高。CHD-APAH患者血清内皮素-1水平与气流阻塞有关,与用力肺活量75%时预测的用力呼气流速成显著的负相关关系(r=-0.5858,P=0.0135)。

由此可见,CHD-APAH患者炎症生物标志物水平升高。呼吸道生理的显著异常可能导致呼吸困难,但不受循环和痰液细胞因子的影响。增加的血清内皮素-1和气道功能障碍之间的关系可能与支气管收缩性能相关。

原始出处:


Andrew Low,et al. Lung Function, Inflammation, and Endothelin‐1 in Congenital Heart Disease–Associated Pulmonary Arterial Hypertension.JAHA.2018. https://doi.org/10.1161/JAHA.117.007249

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    2018-02-16 zhaohui6731
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    2018-02-16 huirong
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    2018-02-14 明天jing

    肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。

    0

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    2018-02-14 爱吃鱼的菜

    学习了.谢谢分享

    0

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