卢蓉,尚小珂,张刚成,周红梅

• 1:武汉亚洲心脏病医院先心病中心心脏动力实验室

摘要(Abstract)：

目的明确肺动脉高压患者的循环内皮细胞(circulating endothelial cells,CECs)计数与右心导管检查结果的相关性。方法入选武汉亚洲心脏病医院2014年1月至2014年12月行右心导管检查确诊肺动脉高压的患者42例,术前均行肺动脉高压常规检查项目。所有患者均行标准右心导管检查,术中同时用EDTA负压采血管采集患者左下肺动脉血50μl,使用流式细胞术检测CECs计数,根据绝对数计算分为三组:A组(26例),CECs计数<20个/ml;B组(11例),CECs计数20~50个/ml;C组(5例),CECs计数>50个/ml。比较三组患者的基本资料、临床心功能评估和右心导管检查的血流动力学参数。结果 A、B、C三组中的先心病相关性肺动脉高压和特发性肺动脉高压分别有18例(69.23%)和7例(26.92%)、8例(72.73%)和2例(18.18%)、3例(60.00%)和1例(20.00%);首次诊断肺动脉高压时间至今分别为(22.43±19.22)个月、(25.56±20.01)个月、(39.80±22.81)个月,差异有统计学意义(P=0.012)。世界卫生组织(WHO)心功能评定Ⅲ/Ⅳ级中,A组22例(84.62%),B组5例(45.45%),C组5例(100.00%),差异有统计学意义(P<0.001)。6 min步行距离,A组(494.27±153.01)m,B组(412.47±76.20)m,C组(241.60±170.80)m,差异有统计学意义(P<0.001)。Borg评分,A组(2.42±2.26)分,B组(3.50±1.23)分,C组(6.00±1.87)分,差异有统计学意义(P<0.001)。N末端B型脑钠肽前体(NT-pro BNP)分别为,A组(283.29±155.57)pg/ml,B组(299.98±57.46)pg/ml,C组(4528.80±599.09)pg/ml,差异有统计学意义(P<0.001)。肌钙蛋白I(阳性)分别为,A组2例(7.69%),B组3例(27.27%),C组3例(60.00%),差异有统计学意义(P<0.001)。D-二聚体分别为,A组(0.17±0.12)μg/ml,B组(0.21±0.18)μg/ml,C组(1.00±1.21)μg/ml,差异有统计学意义(P<0.001)。右心导管检查的血流动力学方面,所有指标的差异均无统计学意义(P>0.05)。结论 CECs与患者的临床心功能状况相关,与肺动脉高压相关的化验室指标相关,但未能显示出右心导管血流动力学参数的相关性。

关键词(KeyWords)： 肺动脉高压;循环内皮细胞;右心导管;流式细胞术

Abstract:

Keywords:

基金项目(Foundation): 武汉市卫计委科研项目(WX-15D09);; 2014年武汉市中青年医疗骨干专项培养项目

作者(Author): 卢蓉,尚小珂,张刚成,周红梅

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