哈萨克族心力衰竭患者血浆和肽素浓度变化及临床意义

Changes and clinical significance of Copeptin levels in Kazaks patients with heart failure

目的探讨哈萨克族心力衰竭(HF)患者血浆和肽素(Copeptin)水平变化以及在临床中的意义。方法选取2009年12月～2010年4月收治的哈族HF患者90例(NYHAⅡ～Ⅳ级),选取同期住院无心功能不全患者30例(NYHAⅠ级),采空腹静脉血,测定血浆Copeptin、总胆固醇(TC)、三酰甘油(TG)、血糖(FPG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、载脂蛋白A1(Apo-A1)和载脂蛋白B(Apo-B),计算体质指数(BMI),超声心动图测量左房内径(LAD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)、左室短轴缩短率(FS)等指标。结果哈族HF患者血浆Copeptin显著高于对照组,并随NYHA心功能分级的升高而升高,各组间差异均有统计学意义(P<0.01)。相关分析显示,血浆Copeption与心功能分级、LAD、LVEDD呈正相关(P<0.01),与LVEF、FS呈负相关(P<0.01)。结论哈族HF患者血浆Copeptin水平显著升高并与HF病情程度有良好的相关性,与左心扩大程度呈正相关。Copeptin可以作为判断哈族HF患者心功能的一个良好指标。

[Objective] To explore the changes and significance of Copeptin in Kazaks patients with heart failure （HF）. [Methods] The 90 Kazaks patients with heart failure （HF） were analyzed as HF group, and 30 patients without heart failure were served as Control group. Every subject＇s plasma Copeptin was detected by ELISA. The parameters of left atrial diameter （LAD）, left ventricle end-diastolic diameter （LVEDD）, left ventricle ejection fraction （LVEF）, fraction shortening （FS） were detected with echocardiography. [Results] The plasma Copeptin levels of HF group were significantly higher than control group （P〈0.01）. Copeptin levels also increased with the classification of NYHA （P 〈0.01）. The levels of Copeptin positively correlated with LAD, LVEDD （P〈0.01）, and was negatively correlated with LVEF, FS （P〈0.01）. [Conduslon] The concentration of Copeptin is increased in Kazaks Patients with heart failure, which is closely associated with NYHAgrading of cardiac function. Measuring plasma Copeptin level may be helpful for judging the severity of HF.