血浆一氧化氮在酒精性心肌病评估中作用

Role of plasma nitric oxide level in the evaluation of alcoholic cardiomyopathy

目的:探讨血浆一氧化氮水平在酒精性心肌病患者病情评估中的作用。方法:对32例酒精性心肌病患者(ACM组)及30例扩张型心肌病患者(DCM组)进行NYHA分级,行超声心动图检查评估左心室舒张末期内径和左室射血分数,检测血浆一氧化氮水平,并将一氧化氮与NYHA分级、左心室舒张末期内径和左室射血分数行相关性分析。结果:ACM组血浆一氧化氮水平明显低于DCM组(P<0.01)。ACM组血浆一氧化氮水平NYHAⅣ级明显低于NYHAⅢ级,NYHAⅢ级明显低于NYHAⅡ级患者,差异均有统计学意义(P<0.01)。酒精性心肌病患者血浆一氧化氮水平与左心室舒张末期内径呈负相关(r=-0.90,95%CI为-0.80^-0.95,P<0.01),与左室射血分数呈正相关(r=0.88,95%CI为0.76~0.94,P<0.01)。结论:酒精性心肌病患者血浆中一氧化氮水平与病情严重程度密切相关。

Objective To investigate the role of plasma nitric oxide level in the evaluation of alcoholic cardiomyopathy.Methods Thirty-two patients with alcoholic cardiomyopathy（ACM group） and 30 patients with dilated cardiomyopathy（DCM group） were graded according to NYHA functional classification.Left ventricular end-diastolic dimension and left ventricular ejection fraction were evaluated with echocardiography and plasma nitric oxide level was detected.The correlation analysis was done between plasma nitric oxide level and NYHA grading,left ventricular end diastolic diameter and left ventricular ejection fraction.Results Plasma nitric oxide level was significantly lower in ACM group than that in DCM group（P0.01）.In ACM group,the plasma nitric oxide level in patients with NYHA Ⅲ was significantly higher than that in patients with NYHA Ⅳ（P0.01）,and was significantly lower than in patients with NYHA Ⅱ（P0.01）.In ACM group,the plasma nitric oxide level was negatively correlated with left ventricular end-diastolic dimension（r=-0.90,95%CI：-0.80～-0.95,P0.01） and positively correlated with left ventricular ejection fraction（r=0.88,95%CI： 0.76～0.94,P0.01）.Conclusion The plasma nitric oxide level is closely correlated with the severity of alcoholic cardiomyopathy.