AN IMBALANCE BETWEEN THE EXCRETION OF THROMBOXANE AND PROSTACYCLIN METABOLITES IN PULMONARY-HYPERTENSION
AN IMBALANCE BETWEEN THE EXCRETION OF THROMBOXANE AND PROSTACYCLIN METABOLITES IN PULMONARY-HYPERTENSION
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DOI：
10.1056/nejm199207093270202
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发表时间：
1992-07-09
影响因子：
158.5
通讯作者：
LOYD, JE
中科院分区：
文献类型：
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作者：
CHRISTMAN, BW;MCPHERSON, CD;LOYD, JE
背景肺动脉高压的特征是肺小动脉和肺小动脉的狭窄以及局灶性血管损伤。由于血栓素A2既是血管收缩剂又是血小板聚集的强刺激物，因此它可能是肺动脉高压的重要介质。它的作用被血管内皮细胞释放的前列环素所拮抗。我们测试的假设，可能是血栓素A2和前列环素的释放之间的不平衡，在肺动脉高压，反映血小板活化和肺血管内皮的异常反应。我们使用放射免疫测定法测量了20名原发性肺动脉高压患者、14名继发性肺动脉高压患者、9名严重慢性阻塞性肺疾病（COPD）患者的24小时尿中血栓素A2的两种稳定代谢物和前列环素的一种代谢物的排泄量。没有肺动脉高压的临床证据，以及23名正常对照。结果。原发性肺动脉高压患者和继发性肺动脉高压患者24小时11-脱氢血栓烷B2（血栓烷A2的稳定代谢物）的排泄量与正常对照组相比增加（分别为3224 ± 482、5392 ± 1640和1145 ± 221 pg/mg肌酐; P
Background. Constriction of small pulmonary arteries and arterioles and focal vascular injury are features of pulmonary hypertension. Because thromboxane A2 is both a vasoconstrictor and a potent stimulus for platelet aggregation, it may be an important mediator of pulmonary hypertension. Its effects are antagonized by prostacyclin, which is released by vascular endothelial cells. We tested the hypothesis that there may be an imbalance between the release of thromboxane A2 and prostacyclin in pulmonary hypertension, reflecting platelet activation and an abnormal response of the pulmonary vascular endothelium.Methods. We used radioimmunoassays to measure the 24-hour urinary excretion of two stable metabolites of thromboxane A2 and a metabolite of prostacyclin in 20 patients with primary pulmonary hypertension, 14 with secondary pulmonary hypertension, 9 with severe chronic obstructive pulmonary disease (COPD) but no clinical evidence of pulmonary hypertension, and 23 normal controls.Results. The 24-hour excretion of 11-dehydro-thromboxane B2 (a stable metabolite of thromboxane A2) was increased in patients with primary pulmonary hypertension and patients with secondary pulmonary hypertension, as compared with normal controls (3224+/-482, 5392+/-1640, and 1145+/-221 pg per milligram of creatinine, respectively; P