摘要
目的观察慢性充血性心力衰竭(CHF)患者血浆肾上腺升压素(ADT)和心钠素(ANP)的变化,以探讨CHF发生发展的病理生理机制。方法采用特异性放射免疫法检测了45例CHF患者治疗前后和20例正常人ADT和ANP的血浆浓度。结果治疗前,ADT血浆浓度在心功能Ⅱ级为(29.98±3.56)ng/L、Ⅲ级为(33.45±3.54)ng/L,Ⅳ级为(20.71±3.37)ng/L,心功能Ⅲ级时达到高峰,心功能Ⅳ级时明显下降,并且低于正常对照组(24.89±2.19)ng/L,心力衰竭各亚组与正常对照组比较,差异均有统计学意义(均P<0.05);经1周药物治疗后,心力衰竭各亚组患者血浆ADT含量下降。治疗前ANP血浆含量在心力衰竭各亚组较对照组明显升高(P<0.05),心力衰竭各亚组间比较差异亦有统计学意义(均P<0.05);治疗后,心力衰竭各亚组均下降,Ⅳ级组与治疗前相比差异有统计学意义(P<0.05),余两组差异无统计学意义(P>0.05)。治疗前ADT和ANP在Ⅱ级组和Ⅳ级组无相关关系,Ⅲ级组有负相关关系(r=-0.46,P=0.04)。结论ADT和ANP共同参与了心力衰竭的病理进程,表明缩血管和舒血管活性肽分子间平衡被打破,反映了心力衰竭的严重程度;短期药物治疗可降低其血浆水平。
Objective To investigate the clinical significance of adrenotensin （ADT） and atrial natriuretic peptides（ANP） in patients with congestive heart failure（CHF） and CHF mechanism. Methods Plasma ADT and ANP levels in 45 patients with CHF before and after medical treatment and 20 healthy control subjects were measured by specific radioimmunoassay. Results Before treatment,ADT plasma level in class Ⅱ and Ⅲ in the patients with CHF were （29. 98±3.56） ng/L and （33. 45±3.54） ng/L,which were higher than those in control group （24. 89±2.19） ng/L,respectively（both P 〈0.05）. ADT plasma levels （20.71 ± 3.37） ng/L in class Ⅳ was higher than that in class Ⅱ , Ⅲ and control group（all P〈0.05）. After one week of treatment, ADT plasma level in class Ⅲ was much lower than that before treatment （ P 〈 0. 05）. There was no significance of ADT plasma concentration in other classes compared to that before treatment. Before treatment,ANP plasma level in CHF groups was higher than that of control （ P 〈0. 05）. There were significant changes among those in class Ⅱ , Ⅲ and Ⅳ （all P 〈0.05）. After treatment, ANP level was decreased in all CHF groups. There was more significant change of ANP level in class Ⅳ than that of ANP before treatment （ P 〈0.05）. Before treatment,there was no relationship between plasma levels of ANP and ADT in class Ⅱ and Ⅳ ANP and ADT. But there was negative corelation in class Ⅲ between ANP and ADT（ r =-0.46, P = 0. 04）. Conclusion Plasma concentration of ADT and ANP varied dynamically in the development of CHF, which showed a regulative change among the vasoactive peptides from intermolecule. ADT and ANP may be involved in different signal transmission paths and might serve as an important assessing index in the patients with CHF. Shortterm medicine treatment can decrease ADT and ANP plasma concentration.
出处
《临床荟萃》
CAS
北大核心
2008年第2期80-83,共4页
Clinical Focus
关键词
心力衰竭
充血性
血管升压素类
心钠素
放射免疫测定
heart failure, congestive
vasopressins
atrial natriuretic factor
radioimmunoassay
