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目的 本研究探讨缺氧对肾上腺髓质素 (AM)合成分泌的影响及AM在缺氧性肺动脉高压中的作用和意义。方法 制备大鼠缺氧性肺动脉高压模型 ,分为对照组和缺氧组 (10 ,2 0 ,30d)。每组 6只。慢性肺心病患者 2 3例 ,对照组 16名。测量肺动脉压力和右心室收缩最大上升速率。应用放射免疫法检测血浆和支气管肺泡灌洗液中AM含量的动态变化。测定慢性肺心病患者急性期和缓解期血浆AM含量变化。结果 缺氧组实验大鼠肺动脉压和右心室最大上升速率高于对照组(P <0 0 1) ;血浆和支气管肺泡灌洗液中AM含量高于对照组 (P <0 0 1) ,且与肺动脉高压变化趋势一致。慢性肺心病患者不同病期血浆AM亦明显高于对照组 (P <0 0 1)。结论 AM参与缺氧性肺动脉高压的病理生理过程 ,在肺血管张力调节中起重要作用。局部和全身性AM增高可能是机体自身内源性抗损伤的代偿反应
Objective This study was to investigate the effects of hypoxia on the synthesis and secretion of adrenomedullin (AM) and the role and significance of AM in hypoxic pulmonary hypertension. Methods The model of hypoxic pulmonary hypertension in rats was established and divided into control group and hypoxia group (10, 20, 30d). 6 per group Twenty-three patients with chronic pulmonary heart disease, 16 patients in the control group. Pulmonary artery pressure and maximum rate of right ventricular contraction were measured. Dynamic changes of AM content in plasma and bronchoalveolar lavage fluid by radioimmunoassay. Determination of acute pulmonary disease in patients with chronic pulmonary heart disease and remission AM content changes. Results The maximal rate of pulmonary arterial pressure and right ventricle in hypoxia group were higher than those in control group (P <0.01). The content of AM in plasma and bronchoalveolar lavage fluid was higher than that in control group (P <0.01) Consistent with the trend of pulmonary hypertension. Patients with chronic cor pulmonale at different stages of plasma AM was also significantly higher than the control group (P <0 01). Conclusion AM participates in the pathophysiological process of hypoxic pulmonary hypertension and plays an important role in the regulation of pulmonary vascular tone. Local and systemic AM increased may be the body’s own endogenous anti-injury compensatory response