P458Changes of pulmonary vasoactive factors and its relation with pulmonary arterial hypertension in patients with high altitude pulmonary edema

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Abstract

Objective: To assess the changes of pulmonary vasoactive factors and its relation with pulmonary arterial hypertension (PAH) in patients with high altitude pulmonary edema (HAPE).

Methods: The levels of plasma intermedin(IMD), adrenomedulin(ADM), endothelin-1 (ET-1), partial pressure of oxygen in artery blood (PaO2), and mean pulmonary arterial pressure (mPAP) were measured in 22 patients with HAPE before treatment and after cure.In addition,the upper mentioned parameters were meated in 30 healthy peoples.

Results: Before treatment,levels of IMD, ADM, ET-1, and mPAP [(174.23±17.44)pg/mL, (77.45±6.87)pg/mL, (93.6±10.22)ng/L, (46.51±7.20)mm Hg, respectively] were markedly higher,and PaO2 [(33.82±5.66)mm Hg] was lower in HAPE patients than those in the the normal control subjects [(62.76±10.60)pg/mL, (22.04±3.15)pg/mL, (35.52±4.52)ng/L, (20.14±3.34)mm Hg, (69.27±3.35)mm Hg, respectively] (all P<0.01). The IMD ADM ET-1 was positively correled with mPAP (r= 0.752 0.733 0.812, respectively, all P<0.01,and PaO2 was netatively correlated with IMD, ADM, ET-1, mPAP(r=-0.689, -0.710, -0.741, -0.744, all P<0.01) in the HAPE patients. After cure, levels of IMD,ADM,ET-1, and mPAP[(65.33±9.88)pg/mL, (23.56±3.53)pg/mL, (36.73±3.90)ng/L,(21.22±3.63)mm Hg, respectively] were markedly lower, and PaO2 [(69.01±3.62)mm Hg] was markedly higher than those before treatment (all P<0.01) in the HAPE patients, all parameters were not markedly differcence compared with those normal control subjects (all P>0.05).

Conclusion: IMD, ADM and ET-1 may play important roles in mechanism of PAH in HAPE. Imbalance of these factors had great effects on the development of hypoxic pulmonary hypertasion.

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