神经肽Y和血管活性肠肽对婴幼儿充血性心力衰竭调控作用的研究

The potential role of neuropeptide Y and vasoactive intestinal peptide in infants with heart failure

目的：探讨血浆神经肽Ｙ（ＮＰＹ）和血管活性肠肽（ＶＩＰ）在婴幼儿充血性心力衰竭过程中的变化及其意义。方法：对３０例急性充血性心力衰竭婴幼儿和３０例正常婴幼儿的血浆ＮＰＹ和ＶＩＰ进行放射免疫测定，并对研究组中的１８例于治疗症状控制后用同样方法复查ＮＰＹ和ＶＩＰ含量。结果：研究组治疗前的血浆ＮＰＹ和ＶＩＰ水平分别为（２９９．７３±１３０．９９）ｎｇ／Ｌ和（３７．１５±１０．５２）ｎｇ／Ｌ，均明显高于正常对照组（７９．５３±２４．５１）ｎｇ／Ｌ和（１０．２８±７．６９）ｎｇ／Ｌ（Ｐ均＜０．０１）。ＮＰＹ升高的程度与心功能有关，心力衰竭越重，ＮＰＹ的含量越高。症状控制后血浆ＮＰＹ水平由（３０１．１１±１３１．７２）ｎｇ／Ｌ降至（１６２．８３±６７．２９）ｎｇ／Ｌ，而ＶＩＰ仍维持在较高水平〔（３９．０８±１０．３０）ｎｇ／Ｌ～（４１．１１±７．４１）ｎｇ／Ｌ〕。结论：ＮＰＹ对心力衰竭的发病有重要病理生理意义，血浆ＮＰＹ含量升高，可作为婴幼儿心力衰竭严重程度和预后不良的指标。维持ＶＩＰ的高水平，有助于对心力衰竭病理过程的控制。

Objective:To investigate the potential role of neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP) in infants with acute congestive heart failure (ACHF).Methods:Plasma NPY and VIP levels were measured by radioimmunoassay in infants with ACHF ( n =30) and control group ( n =30).The levels of NPY and VIP were reexamined in 18 cases of study group after treatment.Results:It showed that plasma of NPY and VIP levels were markedly elevated in study group than that in controls before treatment NPY:(299 73±130 99)ng/L vs.(79 53±24 51)ng/L, P <0 001;VIP:(37 15±10 52)ng/L vs.(10 28± 7 69)ng/L, P <0 01 .Moreover,NPY levels were related to the degree of ACHF,as the heart failure became serious,levels of NPY were also increased.After ACHF were controlled,plasma NPY levels were reduced (301 11±131 72)ng/L vs.(162 83±67 29)ng/L ,but VIP were still kept in high values (39 08± 10 30)ng/L to (41 11±7 41)ng/L .Conclusions:NPY plays an important role in the development of heart failure,it may serve as a useful marker for the poor prognosis.Also,persistent high levels of VIP are beneficial for the control of the pathological process in infants with ACHF.