高血压合并心功能不全患者的血浆心钠素和细胞内钠、钾含量的研究

Assessment of plasma atrial natriuretic peptide and intracellular sodium and potassiam contents in patients with essential hypertension and hypertensiveheart failure

随机选取66例高血压病及55例高血压并心功能不全患者,并与40例正常人对照、测定血浆心钠素(ANP)、红细胞内Na^+、K^+含量。结果表明,血浆ANP含量在高血压病患者明显升高,而合并心功能不全者含量降低,尤以中、重度高血压和心功能Ⅳ级者变化为著,且分别与舒张压(DBP)和病程呈较好相关。轻型高血压病患者红细胞内K^+含量已有下降,中、重度高血压病患者Na^+含量升高,Na^+/K^+比值与DBP正相关,所有心功能不全患者均有细胞内Na^+含量升高,K^+含量下降,可能为高血压发病的重要机理之一。

As one of the natriuretic hormones,it has beenrecently paid more attention to plasma ANP.66patients with hypertension(group 1),55 patientswith hypertensive heart failure(group 2)and 44normal controls(group 3)were studied.Theplasma atrial natriuretic peptide(AND)contentswere much higher in group 1 than those in group 3,especially in severe hypertension(53.6±20.1pg/ml and 30.2±6.8pg/ml,respectively,P<0.001),and much lower in group 2(20.3×4.6pg/ml vs 30.2±6.8pg/ml,P<0.02).The ANPlevels were positively correlated with diastolicblood pressure(DBP)in group 1(r=0.34,P<0.01)and negatively correlated with the course of diseasein group 2(r=-0.45,P<0.005).In mildhypertension,the intr-erythrocytic K^+contentswere lower than those in group 3(260.3±45.2mmol/kg-Hb vs 280.446.2mmol/kg-Hb,P<0.05).The Na^+/K^+ratio was positively corre-lated with DBP in group 2(r=0.32,P<0.002).Theintra-erythrocytic Na^+/K^+ratio was much higherin group 1 and group 2 than that in group 3.Thisstudy suggests that the low plasma ANP level andhigher intra-erythrocytic Na^+/K^+ratio may playimportant roles in the occurrence of heart failureand hypertension respectively.