老年慢性心衰患者神经内分泌激活与淋巴细胞内离子含量变化的关系及意义

The relation between neurohormonal activation and levels of intralymphocyte electrolytes in elderly chronic congestive heart failure patients

目的 探讨老年慢性心衰 (CHF)患者在不同心功能状态下神经内分泌与淋巴细胞内离子含量的关系。方法 采用高效液相及放免法测定 CHF患者血浆去甲肾上腺素 (NE)、血浆肾素活性 (PRA)、血管紧张素 (AT )含量及外周血淋巴细胞内 K+、Na+、Ca2 + 、Mg2 + 离子含量。结果 CHF时血浆 NE、PRA、AT 含量增高 ,尤其 NE、AT 含量增高与心衰严重程度伴行。CHF时 NE含量增加与淋巴细胞内 K+含量呈显著负相关 (r=- 0 584,P<0 0 1 ) ,PRA含量增加与淋巴细胞内 K+含量呈显著正相关 (r=0 698,P<0 0 1 )。结论 提示 CHF时交感神经系统与肾素 血管紧张素系统过度激活。 NE、PRA、AT 含量变化参与心衰的病理生理过程 ,推测NE、PRA含量变化是影响淋巴细胞内 K+、Na+含量变化的主要因素之一。

To investigate the relation between reurohormonal activation and levels of intralymphocyte electrolytes in different cardiac functional status in 20 elderly patients with congestive hear failure(CHF).Methods The levels of plasma norepinephrine(NE)、renin(PRA)、angiotensinⅡ(ATⅡ) and intralymphocytes potassium, sodium, calcium and magnesium were determined.Results The levels of plasma NE、PRA and ATⅡ in the 20 elderly patients with CHF were higher than the healthy controls (P<0 01 for all), especially the elevations of NE、ATⅡ were correlated with severity of CHF. There were a positive relation between the PRA and intralymphocyte sodium (r=0.694,P<0 01) , a negative relation between NE and intralymphocyte potassinm (r= -0.584 , P<0 01) in 20 elderly patients with CHF.Conclusions The results suggest sympathetic system and renin angiotensin system were activated significantly in elderly patients with CHF and the variety of plasma NE、PRA and ATⅡ were involved in pathophysiologic process of CHF, and the resulted change of intralymphocytes potassium and sodium may be one of the principal elements.