The present study was carried out to study the changes in plasma
arial natriuetic peptide (ANP) in asthmatic children and in cases with
chronic obstructive pulmonary disease (COPD) and to correlate these
changes with the ventilatory and cariac functions in the COAD group.
About 105 subjects were selected. From pediatric and chest
Departments, Menha university Hospital. They were calssified into
20 asthmatic children (Group A1), who were reinvestigated 4 weeks
after treatment (Group A2). Their age ranged from 1.5 to 11 years
old. This group of patients was cpmpared with 15 healthy children
matched for the same ages and sex. Another 60 patients with CoPD
were subclassified into 3 subgroups. Subgroup I: included 20 cases
on hospital admission with acute infective exacerbation (subgroup
Ia), those cases were reinvestigated 6 weeks after medical treatment
(subgroupIb). Subgroup II: included 20 patients with COPD corpulmonale
and right-sided heart
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failure. Subgroup III: included 20 patients with COPD without corpulmonale.
Their age ranged from 40 to 74 years old. This group of
patients were compared with 10 healthy subjects matched for the same
ages and sex.
For all groups, plasma ANP was done while ventilatory functions
and echocardiography was done for COPD group only. The main results
of this study, showed that plasma ANP was significantly elevated in
asthmatic children compared with the control group but, it was
significantly higher in subgroups AI in comparison to subgroup A2.
In the COPD group, ANP was significantly elevated in all
subgroups. The highest level in subgroup la, the lowest level was in
subgroup III. ANP was significantly elevated in subgroup II in
comparison to Ib and III subgroups.
Also, ANP was correlated with mean pulmonary artery pressure
(PAP), surface area of right atrium (RAsa), right atrial diameter (RAD),
right ventricuar diameter (RVD) and tight vetxttvculat anterior wall
(RVAW) diameter. The decrease of ANP in subgroup Ib was associated
with improvement in the ventilatory and cardiac functions,
We could conclude that; ANP was elevated and correlated with the
severity of the disease in both asthmatic and COPD cases. Also, it was
correlated with the degree of PAP, right atrial and right ventricular
dimensions. So, ANP may give a new meaning in the future for the
treatment of both asthmatic and COPD cases. |
