慢性充血性心力衰竭病人血浆中叶素的变化及意义

Plasma Intermedin Concentration in Patients with Chronic Heart Faliure

目的:探讨中叶素在慢性充血性心力衰竭(CHF)患者血浆中的变化。方法:放射免疫分析42例健康体检者和46例CHF患者血浆中叶素、脑钠素(BNP)和C反应蛋白(CRP)水平。结果:与正常健康人比较,CHF患者血浆中叶素含量降低53.2%(P<0.01);CHF患者血浆BNP和CRP水平分别增加1658.5%和80.5%(P<0.001)。与心功能Ⅰ-Ⅱ级病人比较,心功能Ⅲ-Ⅳ级病人血浆中叶素较心功能Ⅰ-Ⅱ级病人降低34.7%(P<0.05);心功能Ⅲ-Ⅳ级病人血浆中BNP和CRP含量分别增加257.8%和76%(P<0.001)。结论:CHF病人血浆BNP和CRP在CHF患者中显著增加,其幅度与病情的严重性相一致。CHF患者血浆中叶素浓度的降低与CHF的严重程度相关,血浆中叶素减少可能与CHF的进一步恶化有重要的关系。

Objective To study the clinical significance of determination of changes of plasma levels of intermedin（IMD）,BNP and CRP in patients with chronic heart failure.Methods Plasma IMD,BNP（with RIA） and CRP（with immuno-turbidity） levels were determined in 46 patients with chronic heart failure of various grades（grade Ⅰ-Ⅱ n=31,grade Ⅲ-Ⅳ,n=15） and 42 normal controls. Results Compared with the control group,the plasma IMD level in patients with chronic heart failure was decreased 53.2%（P0.01）,the BNP and CRP were increased 1658.5% and 80.5% respectively（each P0.001）.Compared with the grade Ⅰ-Ⅱ group,the plasma IMD level in grade Ⅲ-Ⅳ was decreased 34.7%（P0.05）,the BNP and CRP levels in grade Ⅲ-Ⅳ were increased 257.8% and 76%（all P0.001） individually.Conclusion Plasma intermedin concentration was significantly decreased in patients with chronic heart failure,which suggests that they play an important role in the pathogenesis of chronic heart failure.