慢性阻塞性肺疾病患者血浆精氨酸加压素及心钠素的变化及临床意义

Plasma Arginine Vasopressin and Artrial Natriuretic Peptide in Patients with Chronic Obstructive Pulmonary Disease:Survey of Changes and Clinical Significance

目的探讨慢性阻塞性肺疾病(COPD)患者急性加重期和稳定期血浆精氨酸加压素(AVP)及心钠素(ANP)的变化及临床意义。方法用放射免疫法测定40例COPD患者(COPD组)血浆AVP和ANP水平,并与动脉血氧分压(PaO2)进行相关分析;另选择35例健康人作为正常对照组。结果(1)COPD组急性加重期和稳定期血浆AVP、ANP水平与正常对照组比较差异有显著性意义(P<0.01);急性加重期血浆AVP、ANP水平与稳定期比较差异有显著性意义(P<0.01);急性加重期PaO2与稳定期比较差异有显著性意义(P<0.01);(2)COPD组急性加重期和稳定期血浆AVP均与ANP呈正相关(P<0.01);AVP及ANP与PaO2均呈负相关(P<0.01)。结论AVP和ANP均可能参与COPD的病理生理过程,并相互作用;检测血浆AVP和ANP水平对反映COPD严重程度和预后有一定的临床价值。

Objective To explore the changes and clinical significance of Arginine Vasopressin （AVP） and Artrial Natriuretie Peptide （ANP） in patients with chronic obstructive pulmonary disease （COPD） at both acute stage and stable stage. Methods The levels of plasma AVP. ANP of 40 patients with COPD （ COPD group） were measured with radioimmunoassay （ RIA）, and correlation analysis with arterial oxygen pressure （ PaO2 ） was carried out. 35 healthy subjects was enrolled as the control group. Results （ 1 ） Plasma AVP and ANP levels of COPD group in both acute stage and stable stage were obviously higher than those of control group （ AVP.. （133.7±51.8）, （55.2±22.2）, （4.7±3.8） ngoL-1; ANP.. （626.7± 161.2）, （300. 6 ± 125.8）, （67.3 ±59. 0） ngoL - 1, all P 〈0. 001 ） ] ; there was significant difference in plasma AVP and ANP levels between patients in acute stage and those in stable stage （ P 〈 0. 001 ） , and significant difference was observed in PaO2 between them [ （50. 0 ± 13.9） vs （76. 3 ± 11.3 ） mmHg, P 〈 0. 001 ] ; （2） In COPD group, AVP correlated positively with ANP in both acute and stable stages （ acute stage ： r = 0. 63, P 〈 0. 001 ; r = 0. 44, P 〈 0. 01 ） ; （3） Both AVP and ANP correlated negatively with PaO2 in acute and stable stage （ acute stage： r = - 0. 53, P 〈 0. 01 ; r = - 0. 50, P 〈 0. 01 ; stable stage： r = -0. 43, P 〈 0. 01 ; r = -0. 54, P 〈 0. 001 ）. Conclusion Both AVP and ANP may participate in pathophysiologic process of COPD, and might affect each other. The detection of AVP or ANP levels is of a practical value in estimating the extent and prognosis of COPD.