| Objective:To observe the relations between the change tendency of angiotensinâ… and angiotensinâ…¡ in the pulmonary circulation and systemic circulation and pulmonary hypertension,and to explore the role of ACEI in treatment of congenital heart disease children with pulmonary hypertension from a creative aspect.Methods:46 children aged from 1 year to 14 years are chosen in the study.14 children without pulmonary and cardiovascular disease are chosen as the control group.Other 32 children are divided into four groups(n=8 in each group) by the ratio of systolic pulmonary artery pressure to systolic aotic pressure:group with increased pulmonary circulation flow but without pulmonary hypertension(group1 SPAP/SAP <0.25);low-grade pulmonary hypertension group(group2 SPAP/SAP 0.25-0.45);moderate pulmonary hypertension group(group3 SPAP/SAP 0.45-0.75);severe pulmonary hypertension group(group4 SPAP/SAP>0.75).5ml blood is drew from the cubital vein of each child in bed in a morning before operation.To the 32 children with congenital heart disease,traumatic pulmonary artery pressure and brachial pressure are measured at the same time during operation.The brachial pressure is looked as aortic pressure.At that time when the pressure is measured,5ml blood is drew from the pulmonary artery,pulmonary vein and cubital vein respectively.Blood examples are processed as the specifications and plasma is preserved.The plasma concentration of angiotensinâ… ,angiotensinâ…¡,ANP and PRA are measured with radioimmunity assay.Results:â‘ PRA of cubital vein plasma in group1,group2,group3 and group4 before operation is significantly higher than that of the control group(P<0.05).The difference between group1 and group2 is not significant(P>.01).The difference between group2,group3 and group4 is significant(P<0.01):PRA of group4>roup3>roup2.â‘¡There is positive correlation between PRA of cubital vein plasma and SPAP/SAP.â‘¢The plasma concentration of angiotensinâ… of brachial vein before operation in group2,group3 and group4 is significantly higher than that of the control group(P<0.05):group4>roup3>roup2(P<0.01). The plasma concentration of angiotensinâ…¡ of cubital vein before operation in group1,group2,group3 and group4 is significantly higher than that of the control group(P<0.05): group4>roup3>roup2>roup1(P<0.01). On the contrary,the plasma concentration of ANP of cubital vein before operation in group1,group2,group3 and group4 is significantly higher than that of the control group(P<0.05): group4 |
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