心力衰竭患者低钠血症及与神经内分泌激素的关系

Relationship between hyponatremia and plasma hormone levels in patients with heart failure

目的 对心衰患者治疗中出现的低钠血症及与血浆激素的关系等有关因素进行分析。方法 15 6例患者均测定入院时血钠浓度 ,并于入院后第二天清晨空腹抽血 ,用放射免疫法测定血浆心钠素 (ANP)和肾素 (RENIN)浓度。观察不同程度心衰患者的血钠浓度与患者基本情况及ANP浓度的关系。结果 提示年龄、心衰程度、心脏病的种类、药物的使用等均可对低钠血症的形成产生影响 ,ANP浓度增高者低钠血症数高于ANP浓度正常组。心衰患者治疗前的ANP浓度和血钠浓度间成负相关。结论 提示心衰时神经内分泌的激活是低钠的一个重要因素。有低钠血症者预后较差 ,病死率明显增高。

S: Objective To analyze the relationship between hyponatremia and plasma hormone levels during the therapy to the patients with heart failure. Methods Concentrations of serum sodium of 156 patients were measured just before hospitalization. Levels of plasma atrial natriuretic piptide(ANP) and rennin were also measured with radioimmunoassay on empty stomach at the second morning after hospitalization. The relationship was studied between different heart failure classification, the patients basic condition and the level of ANP. Results Ages, the severity of heart failure, the origin of heart disease and the drugs may affect the formation of hyponatremia. Compared with the normal ANP level, patients with higher level ANP may have a higher possibility of hyponatremia. Levels of ANP and the serum sodium present a negative correlation.Conclusions Activation of the neurohormone autocrine is a major factor of hyponatremia. Patients with hyponatremia may have worse prognosis and higher death rate.