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 P0.05).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.