Akhmineeva A Kh
Ter Arkh. 2014;86(3):20-3.
To evaluate the vascular endothelium in patients with cardiopulmonary disease, by studying the levels of endothelin-1 (ET-1) and C-type natriuretic peptide (CNP).
Examinations were conducted in 212 dwellers of the Astrakhan Region, including 40 patients with chronic obstructive pulmonary disease (COPD) concurrent with hypertensive disease (HD), 40 patients with COPD concurrent with coronary heart disease (CHD), 27 somatically healthy individuals, 35 patients with Stage II HD, 35 patients with Functional Classes II and III CHD, and 35 patients with moderate and severe COPD.
The patients with COPD concurrent with HD and CHD were found to have endothelial dysfunction manifesting itself in the overproduction of ET-1 and CNP. The level of CNP was statistically significantly higher in the COPD + HD group than in the HD and COPD groups whereas in the COPD + HD group the level of ET-1 remained comparable to that in the COPD and HD groups. This indicates that CNP is a more sensitive indirect marker of endothelial dysfunction and that nitric oxide deficiency is aggravated in the concurrence of COPD and HD as compared to a mononosological entity (HD, COPD).
The concurrence of COPD and CHD is more unfavorable for the development and severity of endothelial dysfunction, which may lead to mutual aggravation syndrome, the rapider progression of the diseases, and the increased frequency of complications.
通过研究内皮素-1（ET-1）和C型利钠肽（CNP）的水平，评估心肺疾病患者的血管内皮功能。
对212名阿斯特拉罕地区居民进行检查，其中包括40例慢性阻塞性肺疾病（COPD）合并高血压病（HD）患者、40例COPD合并冠心病（CHD）患者、27名身体健康者、35例II期HD患者、35例心功能II级和III级的CHD患者以及35例中重度COPD患者。
发现COPD合并HD和CHD的患者存在内皮功能障碍，表现为ET-1和CNP过度生成。COPD + HD组的CNP水平在统计学上显著高于HD组和COPD组，而COPD + HD组的ET-1水平与COPD组和HD组相当。这表明CNP是内皮功能障碍更敏感的间接标志物，并且与单一疾病实体（HD、COPD）相比，COPD和HD并存时一氧化氮缺乏更为严重。
COPD和CHD并存对内皮功能障碍的发生和严重程度更为不利，这可能导致相互加重综合征、疾病进展加快以及并发症发生率增加。
