摘要
目的：探讨充血性心力衰竭（心衰）并发低钠血症与血浆激素的相关性。方法：对５５例充血性心衰患者和４４例健康人同时测定了血钠、血浆肾素（ＰＲＡ）、血管紧张素Ⅱ（ＡＴⅡ）和心钠素（ＡＮＦ）值。结果：心衰患者治疗前血钠值较对照组明显下降，两者比较Ｐ＜０．００１，且血钠值随心衰程度加重而逐渐下降；治疗前血钠值与ＰＲＡ、ＡＴⅡ、ＡＮＦ呈明显负相关（ｒ＝０．３２、ｒ＝０．４１和ｒ＝０．５３），治疗后巯甲丙脯酸组血钠值上升幅度大于血管扩张药组，Ｐ＜０．０１，而利尿剂组治疗前后血钠值无明显变化，Ｐ＞０．０５；治疗后血钠值回升幅度与ＡＴⅡ、ＡＮＦ下降幅度呈明显正相关（ｒ＝０．６４、ｒ＝０．５１）。结论：充血性心衰时出现低钠血症是肾素血管紧张素醛固酮系统活化的标志之一，表明存在高ＰＲＡ、高ＡＴⅡ和高ＡＮＦ血症，应选择转化酶抑制剂进行治疗。血钠可随心功能的恶化进行性下降，重度低钠血症提示预后极差。
Objective:To determine the correlation between hyponatremia and plasma hormones in patients with congestive heart failure.Methods:The serum sodium and plasma renin(PRA),angiotensinⅡ(ATⅡ),atrial natriuretic factor(ANF) were determined in 55 cases of congestive heart failure(CHF) and 44 normal volunteers.Results:It was showed that the serum sodium concentrations were significantly lower in CHF group than that in normal group before treatment ( P <0 001).The more serious CHF,the lower serum sodium concentrations were observed.The serum sodium concentrations were positively correlated with plasma PRA,ATⅡ,ANF in CHF group before treatment( r = 0 32 , r =0 41, r =0 53).The serum sodium concentrations had an increase in captopril group,which was significantly higher than that in vasodilator group after treatment( P <0 01).However,the serum sodium concentrations were not significantly different in diuretic group before treatment compared with after treatment( P >0 05).The serum sodium concentrations were found to be increased,while the plasma ATⅡ,ANF concentrations were declined after treatment.Moreover,the serum sodium levels were positive correlated with plasm ATⅡ and ANF( r =0 64, r =0 51).Conclusions:These data suggest that decrease in serum sodium is associated with the development of CHF and persistent hyponatremia may carry a poor prognosis.
出处
《中国危重病急救医学》
CAS
CSCD
1997年第3期153-155,共3页
Chinese Critical Care Medicine
