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目的:探索高原肺水肿(HAPE)血浆C型钠尿肽(CNP)、醛固酮(ALD)和血管内皮生长因子(VEGF)的变化及意义。方法:28例HAPE分为初发性HAPE(pHAPE)18例和再发性HAPE(rHAPE)10例两组;ELISA法测定VEGF;RIA法测定ALD、CNP,数据以x±s表示,t检验分析。结果:pHAPE治疗前的VEGF、ALD、CNP及rHAPE的ALD、CNP高于治疗后,rHAPE的VEGP、ALD、CNP值均高于pHAPE,P<0.01、P<0.05。结论:急性缺氧诱导了VEGF、ALD、CNP分泌,在rHAPE是更显著的。它们在HAPE的发病中可能发挥了关键性作用,也是重返高原再次发生HAPE的重要原因,CNP的增加具有抗肺动脉高压,起内源性保护作用。
Objective: To explore the changes of plasma C-type natriuretic peptide (CNP), aldosterone (ALD) and vascular endothelial growth factor (VEGF) in high altitude pulmonary edema (HAPE) Methods: 28 cases of HAPE were divided into two groups: initial HAPE (pHAPE) 18 cases and recurrent HAPE (rHAPE) 10 cases. VEGF was detected by ELISA method. ALD and CNP were measured by RIA method. analysis. Results: The levels of ALD and CNP in VEGF, ALD, CNP and rHAPE before pHAPE treatment were higher than those in control group. The values of VEGP, ALD and CNP in rHAPE were higher than those in pHAPE (P <0.01, P <0.05). Conclusion: Acute hypoxia induces the secretion of VEGF, ALD and CNP, which is more prominent in rHAPE. They may play a key role in the pathogenesis of HAPE and are also an important reason for HAPE re-entering the plateau. The increase of CNP has anti-pulmonary hypertension and plays an endogenous protective effect.