慢性心衰患者血浆内皮素水平及其与肾功能的关系

Plasma endothelin and its relationship with-renal function in patients with chronic heart failure

目的研究慢性心衰（ＣＨＦ）患者血浆内皮素（ＥＴ）水平并探讨其与肾功能的关系。方法测定和比较了１８例心功能Ⅱ级患者和３５例心功能Ⅲ～Ⅳ级患者及１９例健康人的血浆ＥＴ，并分析了ＣＨＦ患者ＥＴ与血肌酐（Ｓｃｒ）、尿素氮（ＢＵＮ）及内生肌酐清除率（Ｃｃｒ）的关系。结果心功能Ⅲ～Ⅳ级患者ＥＴ（６．８６±１．３５）ｎｇ／Ｌ明显高于健康对照组（４．１２±１．０３）ｎｇ／Ｌ（Ｐ＜０．０１）；心功能Ⅱ级组ＥＴ（４．７１±１．１０）ｎｇ／Ｌ较健康对照组（４．１２±１．０３）ｎｇ／Ｌ高，但无统计学意义（Ｐ＞０．０５）。ＣＨＦ患者ＥＴ与ＢＵＮ呈正相关（ｎ＝５３ｒ＝０．４９７４Ｐ＜０．０１），与Ｃｃｒ呈低度负相关（ｎ＝５３ｒ＝０．３７６６Ｐ＜０．０１）。结论ＣＨＦ患者ＥＴ明显升高并与心衰严重程度有关。

Objective: To study the alteration of plasma endothelin in patients with chronic heart failure(CHF)and its relationship with renal function.Methods: the plasma endothelin was measured and compared in 18 patients with class ⅡCHF,35 patients with classⅢ～Ⅳ CHF and 19 healthy subjects,and its correlation with Scr, BUN and Ccr was analysed.Results:The ET levels of classⅢ～ⅣCHF patients(6.86±1.35)ng/L were markedly higher than that of healthy subjects(4.12±1.03)ng/L(P<0.01);ET leveals of class Ⅱ patients(4.71±1.10)ng/L were higher than that of healthy subjects but had no statistical difference.Plasma ET levels correlated with BUN(r=0497 4,P<0001, n=53)in the two groups of CHF patients.Correlation was negative between plasma ETand Ccr(r=-0.376 6, P<0.01, n=53).Conclusion:The plasma ET levals are high in CHF ,patients.The more serious the CHF, the higher the ET levels.ET might be involved in the impairment of renal function in CHF patients.