摘要
目的:观察不同病因不同心功能级别充血性心力衰竭(心衰,CHF)患者血清生长激素(GH)和血浆肾上腺髓质素(ADM)的水平变化,并比较二者在CHF中的诊断价值及其灵敏度。方法:将受试对象分为非心衰组30例和心衰组72例。心衰组中冠心病31例,高血压病12例,风湿性心脏病16例,扩张型心肌病13例。其中NYHA心功能分级第Ⅱ级组22例,第Ⅲ级组20例,第Ⅳ级组30例。分别用放射免疫法和酶联免疫法测定血浆ADM、血清BNP和GH的浓度,同时行心脏彩色多普勒超声测定左室舒张末内径(LVED)和左室射血分数(LVEF)。结果:心衰组GH水平较非心衰组升高(P<0.05);ADM两组间比较差异无显著性。不同病因组间比较,ADM在各病因组高于其他病因组(P<0.05),而其他病因组间比较无统计学差异;GH在各病因组比较无统计学意义,GH和ADM在心功能第Ⅱ级和第Ⅲ级依次升高,Ⅳ级组低于第Ⅲ级、高于第Ⅱ级,各组间比较均P<0.05,GH和ADM诊断心衰的曲线下面积为0.792和0.585,灵敏度和特异度HG均明显优于ADM(P<0.05),GH和ADM均与心功能级别呈正相关,P值分别为<0.001和<0.05。结论:GH有助于CHF的诊断,ADM对CHF的诊断价值不大;GH诊断CHF的灵敏度和特异度均优于ADM。
Objective:To observe erum/plasma levels of growth hormone(GH)and adrenomedullin(ADM) and evaluate their diagnostic value in congestive heart failure(CHF) and contrast their sensitivity and specificity.Methods:The blood samples were obtained from 72 patients with CHF and 30 patients without CHF.We measured their serum/plasma levels of GH and ADM by ELISA and radioimmunoassay.At the same time all patients received colorful doppler ultrasoncardiogram to determine left ventricular end-dilate diameter(LVED) and left ventricular ejection fraction(LVEF).Results:GH levels in CHF group were higher than those in non-CHF group(P<0.05).ADM levels were lower than those in non-CHF group(P<0.05).ADM were higher in rheumatic heart disease group than hypertension group(P<0.05).GH and ADM levels in NYHA class Ⅲ were higter than calss Ⅱ(P<0.05),class Ⅳ were lower than classⅢ,but higher than classⅡ(P<0.05).The area under the receiver operating characteristic(ROC) curve of GH and ADM were 0.792 and 0.585.The sensitivities and specificities of GH were better than those of ADM.GH and ADM levels had positive correlations to different classification of heart function(P<0.001,P<0.05).Conclusion:GH can help to establish the diagnosis of CHF.ADM levels are not helpful to the diagnosis of CHF.The sensitivity and specificity of GH were better than that of ADM.
出处
《临床医药实践》
2007年第11期1056-1059,共4页
Proceeding of Clinical Medicine
