充血性心力衰竭患者血钠水平与神经内分泌激素及脑钠肽水平关系的临床研究

Clinical study of the relationship between serum sodium concentration and plasma concentration of neuroendocrine hormone,brain natriuretic peptide in patients with congestive heart failure

目的探讨充血性心力衰竭患者血钠水平与血浆肾素(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)及脑钠肽(BNP)水平的关系。方法 73例NYHAⅡ、Ⅳ级住院患者按血清钠水平分为正常血钠组(41例)和低血钠组(32例),测定并比较两组患者的血浆PRA、AngⅡ、ALD及BNP水平,并分析血清钠水平和上述指标的相关性;根据心功能级别分为心功能Ⅱ级组(20例)、Ⅲ级组(22例)和Ⅳ级组(31例),并分别进行组间血钠、PRA、AngⅡ、ALD、BNP水平比较。结果①与正常血钠组相比,低血钠组的心力衰竭患者血浆PRA、AngⅡ、ALD、BNP水平均显著升高;②相关分析显示,血钠与血浆PRA、AngⅡ、ALD、BNP呈显著负相关;③与心功能Ⅱ组比较,心功能Ⅲ、Ⅳ组的血浆PRA、AngⅡ、ALD、BNP水平显著升高,而血钠水平显著降低(P<0.05)。结论慢性充血性心力衰竭患者血钠水平与PRA、AngⅡ、ALD、BNP水平呈负相关,可能促进慢性心力衰竭患者血浆PRA、AngⅡ、ALD、BNP分泌增加。

【Objective】 To explore the relationship between serum sodium concentration and plasma concentration of neuroendocrine hormone,brain natriuretic peptide in patients with congestive heart failure.【Methods】 73 patients with congestive heart failure were divided into two groups according to their serum sodium（Na） levels： normal serum sodium group（41 objects） and hyponatremia group（32 objects）.The levels of plasma rennin（PRA）,angiotensin Ⅱ（Ang Ⅱ）,aldosterone（ALD） and brain natriuretic peptide（BNP） in both groups were determined and compared;and their correlation was analyzed.73 patients were too divided into three groups according to their NYHA classification,the levels of plasma PRA,Ang Ⅱ,ALD and BNP were compared.【Results】 The levels of plasma PRA、Ang Ⅱ,ALD and BNP were significantly elevated in hyponatremia patients as compared with norm serum sodium group patients.Serum sodium was negatively correlated with the levels of plasma PRA,Ang Ⅱ,ALD,BNP.The levels of plasma PRA,Ang Ⅱ,ALD and BNP were significantly elevated in NYHA Ⅲ,Ⅳ than NYHA Ⅱ;the levels of serum sodium was significantly lower in NYHA Ⅲ,Ⅳ than NYHA Ⅱ.【Conclusion】 Serum sodium was negatively correlated with the levels of plasma PRA,Ang Ⅱ,ALD,BNP,and hyponatremia may improve the increase the levels of plasma PRA,Ang Ⅱ,ALD,BNP in patients with congestive heart failure.