Martyniuk T V, Chazova I E, Masenko V P, Volkov V N, Belenkov Iu N
Ter Arkh. 1998;70(4):33-6.
Assessment of RAAS and vasopressin in patients with primary pulmonary hypertension (PPH).
Activity of plasma renin (APR), angiotensin-converting enzyme (ACE), plasma levels of angiotensin II (AII) and vasopressin (VP), serum concentration of aldosteron (AS) were measured by radioimmunoassay and enzyme immunoassay in 21 PPH patients with circulatory failure (age 34.7 +/- 2.1 years), 11 patients with NYHA functional class II-III, 10 with class IV, and 10 control subjects (age 29.8 +/- 1.5 years).
Compared to controls, 21 PPH patients had elevated RAAS parameters: APR up to 3.52 ng/ml/h (p < 0.05), activity of ACE up to 43.13 units, AII level up to 33.93 ng/ml (p < 0.01), AS up to 468.86 ng/ml (p < 0.01), VP up to 5.26 ng/ml (p < 0.001). Circulatory failure progression resulted in activation of all the RAAS components. This and VP activation was the greatest in PPH patients with ACE > 5 ng/ml/h. PPH patients with mean pressure in the pulmonary artery higher than 60 mm Hg demonstrated higher ARP, AS, VP, AII, ACE than those who had this pressure under 60 mm Hg.
PPH patients display a noticeable activation of RAAS and VP. This activation seems to be secondary as the changes increase with elevation of the pressure in the pulmonary artery and aggravation of circulatory insufficiency. Plasma renin activity determines the degree of RAAS activation as a whole. The discovered activation of RAAS in PPH gives grounds for doubts in the validity of using ACE inhibitors in the treatment of PPH.
评估原发性肺动脉高压（PPH）患者的肾素-血管紧张素-醛固酮系统（RAAS）和血管加压素。
采用放射免疫分析法和酶免疫分析法，对21例伴有循环衰竭的PPH患者（年龄34.7±2.1岁）、11例纽约心脏协会（NYHA）心功能Ⅱ-Ⅲ级患者、10例Ⅳ级患者以及10例对照者（年龄29.8±1.5岁）测定血浆肾素活性（APR）、血管紧张素转换酶（ACE）活性、血管紧张素Ⅱ（AII）和血管加压素（VP）的血浆水平、醛固酮（AS）的血清浓度。
与对照组相比，21例PPH患者的RAAS参数升高：APR高达3.52 ng/ml/h（p<0.05），ACE活性高达43.13单位，AII水平高达33.93 ng/ml（p<0.01），AS高达468.86 ng/ml（p<0.
