Metabolites of the L-arginine-NO pathway in patients with left-to-right shunt.
Metabolites of the L-arginine-NO pathway in patients with left-to-right shunt.
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发表时间：
2001
影响因子：
0.7
通讯作者：
M. Gorenflo;C. Zheng;A. Pöge;M. Bettendorf;E. Werle;W. Fiehn;H. Ulmer
中科院分区：
文献类型：
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作者：
M. Gorenflo;C. Zheng;A. Pöge;M. Bettendorf;E. Werle;W. Fiehn;H. Ulmer
目的 已发现左向右分流和肺动脉高压患者的 L-精氨酸-NO 途径代谢物的内源性产生发生改变。本研究的目的是分析年龄和左向右分流的程度对患有左向右分流的儿童和年轻人血浆中 L-精氨酸、环磷酸鸟苷 (cGMP)、亚硝酸盐和硝酸盐水平的影响。方法 29 例室间隔缺损 (n=18)、房间隔缺损 (n=6) 和房室管 (n=5) 患者，当肺血流与体循环血流量 (Qp/Qs) 小于 1.5 时被分入组 (n=10)，当 Qp/Qs > 或 = 1.5 时分入组 (n=19)。在心导管插入术中，从肺静脉或左心室采集血样。采集了 33 名对照者的外周静脉血。 cGMP水平通过放射免疫测定法测定，L-精氨酸、亚硝酸盐和硝酸盐水平通过高效液相色谱(HPLC)测定。结果 II 组的 L-精氨酸血浆水平低于对照组（51.7 [23.3-82.2] vs 60.5 [32.4-85.9] pmol/l；KRUSKAL-WALLIS 得出的 p < 0.05）。年龄不影响 L-精氨酸血浆水平 (p = 0.30)。 cGMP 水平取决于年龄 (p<0.01) 和平均肺动脉压 (p<0.01)，但不取决于高肺血流量 (p=0.85；方差分析)。两组的血浆亚硝酸盐和硝酸盐与对照组相比没有差异（亚硝酸盐：26.0 [23.5-31.0] 微摩尔/升；硝酸盐：26.8 [24.0-32.0] 微摩尔/升）。结论年龄和肺动脉压对血浆cGMP 有重要影响。单独测量血浆中的亚硝酸盐和硝酸盐可能无法反映内源性 NO 的产生。未来的研究应该评估 L-精氨酸血浆水平在接受缺损修复的高肺血流量患者中的作用。
OBJECTIVES The endogenous production of metabolites of the L-arginine-NO pathway has been found to be altered in patients with left-to-right shunt and pulmonary hypertension. The objective of this study was to analyze the influence of age and of the magnitude of the left-to-right shunt on plasma levels of L-arginine, cyclic guanosine monophosphate (cGMP), nitrite and nitrate in children and young adults presenting with left-to-right shunt. METHODS Twenty-nine patients with ventricular septal defect (n=18), atrial septal defect (n=6) and atrioventricular canal (n=5) were assigned to group I when the ratio of pulmonary to systemic blood flow (Qp/Qs) was less than 1.5 (n=10) and to group II when Qp/Qs > or = 1.5 (n=19). At cardiac catheterization blood samples were taken from the pulmonary vein or left ventricle. In 33 controls peripheral venous blood was obtained. cGMP levels were determined by radioimmunoassay, L-arginine, nitrite and nitrate by high performance liquid chromatography (HPLC). RESULTS L-arginine plasma levels were lower in group II than in controls (51.7 [23.3-82.2] versus 60.5 [32.4-85.9] pmol/l; p < 0.05 by KRUSKAL-WALLIS). Age did not influence the L-arginine plasma levels (p = 0.30). cGMP levels depended on age (p<0.01) and mean pulmonary artery pressure (p <0.01) but not on high pulmonary blood flow (p=0.85; ANOVA). Plasma nitrite and nitrate were not different in both groups and when compared with controls (nitrite: 26.0 [23.5-31.0] micromol/l; nitrate: 26.8 [24.0-32.0] micromol/l). CONCLUSIONS Age and pulmonary artery pressure exert important effects on plasma cGMP. Measurement of nitrite and nitrate in plasma alone may not reflect the endogenous NO production. Future studies should evaluate the role of plasma levels of L-arginine in patients with high pulmonary blood flow undergoing repair of their defect.