血浆和肽素、N末端脑钠肽前体和肾上腺髓质素前体N端20肽与慢性心力衰竭的关系研究

Relationship between plasma copeptin,proadrenomedullin N-terminal 20 peptide,N-terminal pro-brain natriuretic peptide levels and chronic heart failure

目的:探讨血浆和肽素、肾上腺髓质素前体N端20肽(proadrenomedullin N-terminal 20 peptide,PAMP)、N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)水平和慢性心力衰竭(chronic heart failure,CHF)及其严重程度的相关关系。方法:分别入选CHF患者72例和32例非CHF对照,检测纳入对象血浆和肽素、PAMP和NT-proBNP水平,心脏彩超评价心脏的结构和功能。结果:CHF患者血浆和肽素、NT-proBNP水平与对照组相比明显升高(P<0.001),并随纽约心脏病协会(New York heart association,NYHA)分级的增加而升高。和肽素分别与左室舒张末期内径值(r=0.508)、血肌酐(r=0.320)、NYHA分级(r=0.567)、NT-proBNP(r=0.412)呈显著正相关(均有P<0.01),与左室射血分数呈负相关(r=-0.663,P<0.01)。CHF患者血浆PAMP水平与对照组相比无显著差异。结论:血浆和肽素、NT-proBNP水平在CHF中显著升高,并与CHF的严重程度密切相关。

Objective：To investigate the relationship between plasma copeptin, proadrenomedullin N-terminal 20 peptide （PAMP）, N- terminal pro-brain natriuretic peptide（NT-proBNP） levels and severity of chronic heart failure（CHF）. Methods ：Seventy-two patients with CHF and 32 non-CHF controls were enrolled. Plasma copeptin and PAMP concentrations were measured by ELISA and concen- tration of NT-proBNP was detected by triaged detection instrument. Cardiac structure and function were evaluated by color Doppler ultrasound. Results：Plasma copeptin and NT-proBNP levels were significantly higher in patients with CHF than in non-CHF controls （P〈0.001） ,which were elevated with the increase of the New York heart association（NYHA） class. Concentration of copeptin was posi- tively correlated with left ventricular end-diastolic diameter （LVEDD） （r=0.508）, serum creatinine （r=0.320）, NYHA class （r=0.567）, NT-proBNP（r=0.412） （all P〈0.01） and was negatively correlated with left ventricular ejection fraction（r=-0.663,P〈0.01）. There was no significant difference in terms of plasma PAMP levels between patients with CHF and non-CHF controls. Conclusions ： Plasma copeptin and NT-proBNP levels are higher in patients with CHF and are closely related with the severity of CHF.