Relation of arachidonate metabolites to abnormal control of the pulmonary circulation in a child.
Relation of arachidonate metabolites to abnormal control of the pulmonary circulation in a child.
复制标题
花生四烯酸代谢物与儿童肺循环异常控制的关系。
DOI：
10.1164/arrd.1985.131.1.171
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
Mellins,RB
中科院分区：
文献类型：
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作者：
Barst,RJ;Stalcup,SA;Steeg,CN;Hall,JC;Frosolono,MF;Cato,AE;Mellins,RB
为了评价花生四烯酸代谢物在调节肺血管张力中的作用，我们对一名17个月大的女孩进行了多项研究，该女孩患有特发性肺动脉高压、全身性动脉低氧血症（由于通气-灌注不匹配）和血栓素A2（TXA 2）与前列环素（PGI 2）比值升高（由于TXA 2（分别以其稳定代谢物TXB 2和6-keto-PGF 1 α测量）升高）。静脉输注PGI 2降低了平均肺动脉压（从80到47 mmHg），增加了心输出量（从3.43到3.97 L/min），增加了全身动脉血氧饱和度（从60%到72%），并降低了TXB 2与6-keto-PGF 1 α的比值（从5.9到0.2）;平均全身动脉压不变。在本例患者中，应用硝苯地平或地尔硫卓降低TXB 2/6-keto-PGF 1 α比值也可降低肺动脉高压，增加全身动脉血氧饱和度。硝苯地平和地尔硫卓通过降低TXB 2降低比值。前列环素通过升高6-keto-PGF 1 α降低了该比值。这些研究支持了TXA 2和PGI 2之间的平衡对肺血管张力有重要影响的假设。
To evaluate the role of arachidonate metabolites in regulating pulmonary vascular tone, we performed multiple studies on a 17-month-old girl with idiopathic pulmonary hypertension, systemic arterial hypoxemia (due to ventilation-perfusion mismatching), and an elevated thromboxane A2(TXA2) to prostacyclin (PGI2) ratio due to increased TXA2(measured as their stable metabolites, TXB2and 6-keto-PGF1α, respectively). Intravenous infusions of PGI2reduced mean pulmonary arterial pressure (from 80 to 47 mmHg), increased cardiac output (from 3.43 to 3.97 L/min), increased systemic arterial oxygen saturation (from 60 to 72 percent), and decreased the TXB2to 6-keto-PGF1αratio (from 5.9 to 0.2); mean systemic arterial pressure was unchanged. Pharmacologically decreasing the TXB2to 6-keto-PGF1αratio with administration of nifedipine or diltiazem also reduced pulmonary hypertension and increased systemic arterial oxygen saturation in this patient. Nifedipine and diltiazem decreased the ratio by decreasing TXB2. Prostacyclin decreased the ratio by increasing 6-keto-PGF1α. These studies support the hypothesis that the balance between TXA2and PGI2is an important influence on pulmonary vascular tone.