[Changes of NO and ET-1 in the blood of patients with chronic pulmonary heart disease].

OBJECTIVE

To study the changes of nitric oxide (NO), and endothelin-1 (ET-1) in patients with chronic pulmonary heart disease (CPHD), and to understand its pathophysiology, observe its severity, assess its prognosis and find clues to some new management methods.

METHODS

Forty-five patients with CPHD at the acute exacerbation stage, 20 patients with CPHD at the stable stage and 18 healthy controls were studied. The NO and ET-1 levels were measured by spectrophotometry and radioimmunoassay respectively.

RESULTS

1. The ratio of ET-1/NO in the patients with CPHD at the acute exacerbation stage was higher than that in the patients at the stable stage (P < 0.05), and heathily controls (P < 0.05), the ratio of ET-1/NO in the patients with CPHD at the stable stage was higher than that in the control group (P < 0.05); 2. The NO level in the patients with CPHD at the acute exacerbation stage or stable stage was positively related with PO2(r = 0.85, P < 0.05, r = 0.72, P < 0.05), but negatively related with PCO2(r = -0.54, P < 0.05, r = -0.52, P < 0.05); the ET-1 level in the patients with CPHD at the acute exacerbation stage or stable stage was negatively related with PO2(r = -0.72, P < 0.05, r = -0.53, P < 0.05), but positively related with PCO2(r = 0.55, P < 0.05, r = 0.53, P < 0.05); 3. The serial changes of NO and ET-1 also demonstrated these correlations; 4. The NO level was elevated in those patients with better symptomatic improvement following management (P < 0.05), while the ET-1 level and the ratio of ET-1/NO decreased significantly in the patients with symptomatic improvement (P < 0.05), and there was no significant change in the patients with no symptomatic improvement following management or in the dead patients(P > 0.05).

CONCLUSION

The imbalance between ET-1 and NO exists in patients with CPHD, and it is closely associated with hypoxia and may play an important role in the occurrence and development of pulmonary hypertension and CPHD. NO and ET-1 can serve as indicators to observe the disease severity and assess its prognosis.