成人先天性心脏病的血管紧张素Ⅱ、醛固酮和去甲肾上腺素激活及临床意义

The leve of AngⅡ,ALD and EN and the chronic heart failure syndrome in adults with congenital heart disease

目的探讨成人先天性心脏病(先心病)是否存在血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)和去甲肾上腺素(NE)激活及其临床意义。方法选取100例成人先心病患者,检测其AngⅡ、ALD和NE;另选取年龄及性别与之相匹配的30名健康体检成人作为对照组。结果成人先心病血循环中的AngⅡ(188.3±11.5)ng/L、ALD(546.1±42.3)pmol/L、NE(2.17±0.08)nmol/L与对照组比较明显增高(均P<0.01)。3个亚组随着疾病严重程度的加重,神经内分泌的激活就越明显。结论成人先心病的AngⅡ、ALD和NE明显激活并具有慢性心力衰竭的特征,并与疾病的严重性密切相系。

Objective To detect angiotensin Ⅱ （Ang Ⅱ ）, aldosterone （ALD） and norepinephfine （NE）, and explore whether Ang Ⅱ , ALD and EN activation exists in adults with congenital heart disease. Methods Ang Ⅱ , ALD and NE were determined in 100 adults with congenital heart disease, and 30 cases of the control group were enrolled in the study. Results The serum NE（2.17±0.08）nmol/L and the plasma AngⅡ （188.3±11.5） ng/L,ALD （546.1±42.3）pmol/L in adults with congenital heart disease were higher than that in normal controls （P〈0.01）. There was a highly significant stepwise increase in Ang Ⅱ, ALD and NE according to New York Heart Association class, with even asymptomatic patients having evidence of significant neurohormonal activation. Conclusion Ang Ⅱ ,ALD and EN activation in adult congenital heart disease bears the hallmarks of chronic heart failure, relating to symptom severity.