充血性心力衰竭患者血浆精氨酸加压素变化

Changes of plasma immunoreactive arginine vasopressin contents in patients with congestive heart failure

用放免法测定106例心脏病患者及30例正常人的血浆兔疫活性精氨酸加压素(ir-AVP)含量,发现心功能Ⅱ级以上患者血浆ir-AVP水平明显高于正常对照组(P<0.05)。合并房颤者的ir-AVP低于无房颤者(P<0.01),低钠血症患者的ir-AVP则高于正常血钠者(P<0.01)。相关分析显示患者组血浆ir-AVP与血浆透压无关,而与血浆血管紧张素Ⅱ含量有弱相关(r=0.256,P<0.01)。结果提示心力衰竭时不适当的AVP分泌增多与稀释性低钠血症有关。

Plasma contents of immunoreactive arginine vasopressin (ir-AVP) Were measured by radioimmunoassay in 106 cardiac patients and 30 normal persons. The results showed that plasma ir-AVP levels in patients of class Ⅰ (New York Heart Association Classification), class Ⅲ and class Ⅳ were significantly higher than normal group (41.47 ±3.83, 45.32±4.16, 47.12 ± 7.46 vs 28.30 ± 2.78 ng/L, respectively, P<0.05). Plasma ir-AVP levels in patients complicated with atrial fibrillation were significantly lower than patients without atrial fibrillation (36.38±3.29 vs 46.05 ± 2.92 ng/L, P<0.01). Plasma ir-AVP contents in 34 patients with hyponatrimia were higher than 46 patients without hyponatrimia (50.78 ± 3.87 vs 36.59 ± 2.42 ng/L, p<0.0l). Plasma ir-AVP contents correlated weakly to plasma angiotensin Ⅱ contents (r = 0.256, P<0.01, n = 106), but not to plasma osmolality (r = 0.190, n=80, P>0.05); The results indicated that inappropriately elevated ir-AVP levels were associated with dilution hyponatrimia in patients with congestive heart failure.