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目的:探讨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及其干预治疗。方法:60例高原慢性肺心病急性加重期患者随机分为3组,每组20例。3组抗感染、祛痰、平喘治疗相同。氧疗组:给予持续吸氧,氧流量1.5~3.0L.min-1,使动脉血氧分压(PaO2)保持在55mmHg以上;红景天组:口服红景天胶囊每次2.0g,每天3次.d-1。常规治疗组:给予常规治疗。在治疗前、治疗3周后,采用酶联免疫吸附法检测血清bFGF水平,用超声心动仪测平均肺动脉压(mPAP)和用血气分析仪测PaO2。并以30例慢性阻塞性肺疾病(COPD)和30例当地健康人作对照。结果:肺心病组血清bFGF(87.25±12.10)pg·mL-1、mPAP(45.66±5.61)mmHg,显著高于COPD组[分别为(55.02±9.08)pg·mL-1、(22.98±2.41)mmHg,均P<0.01),COPD组显著高于健康人对照组[分别为(49.83±8.78)pg·ml-1、(20.34±2.23)mmHg,均P<0.01);肺心病组PaO2(38.68±4.46)mmHg显著低于COPD组(58.05±6.18)mmHg,COPD组显著低于健康人对照组(66.57±5.48mmHg,均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=0.788、0.674,均P<0.01),与PaO2水平呈显著负相关(r=-0.735、-0.587,均P<0.01)。治疗后,肺心病3组患者血清bFGF、mPAP较治疗前显著降低、PaO2显著升高(均P<0.01),但氧疗组改善较红景天组显著、红景天组较常规治疗组显著,(均P<0.05)。结论:高原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的形成有一定关系,氧疗和红景对其有显著治疗作用。
Objective: To investigate the role of basic fibroblast growth factor (bFGF) in the pathogenesis of hypoxic pulmonary hypertension and its intervention therapy. Methods: Sixty patients with acute exacerbation of chronic pulmonary heart disease in the plateau were randomly divided into three groups (20 in each group). 3 anti-infective, expectorant, asthma treatment the same. Oxygen therapy group: given continuous oxygen, oxygen flow 1.5 ~ 3.0L.min-1, the arterial partial pressure of oxygen (PaO2) remained above 55mmHg; Rhodiola group: oral Rhodiola capsules 2.0g per day 3 times .d-1. Routine treatment group: given conventional treatment. Before treatment, after 3 weeks of treatment, serum bFGF level was measured by enzyme-linked immunosorbent assay, mean pulmonary arterial pressure (mPAP) was measured by echocardiography and PaO2 was measured by blood gas analyzer. 30 cases of chronic obstructive pulmonary disease (COPD) and 30 healthy local people as a control. Results: The serum levels of bFGF (87.25 ± 12.10) pg · mL-1 and mPAP (45.66 ± 5.61) mmHg in COPD group were significantly higher than those in COPD group [(55.02 ± 9.08) pg · mL- mmHg, P <0.01). The COPD group was significantly higher than that of the control group [(49.83 ± 8.78) pg · ml-1, (20.34 ± 2.23) mmHg, all P <0.01) ± 4.46) mmHg was significantly lower than that of COPD group (58.05 ± 6.18) mmHg, the COPD group was significantly lower than the healthy control group (66.57 ± 5.48mmHg, P <0.01). The level of bFGF in cor pulmonale and COPD group was positively correlated with mPAP (r = 0.788,0.674, all P <0.01), and negatively correlated with PaO2 (r = -0.735, -0.587, all P <0.01) . After treatment, the serum levels of bFGF and mPAP in the three groups of patients with pulmonary heart disease were significantly lower than those before treatment and PaO2 was significantly higher (all P <0.01), but the improvement in oxygen therapy group was more significant than that of Rhodiola, compared with the conventional treatment group , (All P <0.05). CONCLUSION: Serum bFGF levels are significantly elevated in patients with plateau patients with chronic cor pulmonale, which may be related to the formation of chronic hypoxic pulmonary hypertension. Oxygen therapy and Hongjing have significant therapeutic effects on them.