60例慢性收缩性心力衰竭患者中医证型与血浆AVP、尿液水通道蛋白2的相关性研究

Correlation between Distribution Features of Syndrome Types and Expression of AVP and AQP-2 in 60 Patients with Chronic Systolic Heart Failure

目的:研究慢性收缩性心力衰竭患者不同心功能分级中医证型的分布特点及与血浆AVP、尿液水通道蛋白2的相关性。方法:收集2009年10月—2010年6月60例慢性收缩性心力衰竭住院患者的临床资料,分析不同心功能分级的中医证型分布规律,并检测患者血浆AVP、尿液水通道蛋白2的含量。结果:慢性收缩性心力衰竭心功能Ⅱ级患者气虚证最为常见(30/34,88.2%),其次是阴虚证(21/34,61.8%)、血瘀证(19/34,55.9%),组合证候气阴两虚证最常见(18/34,52.9%);心功能Ⅲ、Ⅳ级患者阳虚证最为常见(22/26,84.6%),其次为气虚证(18/26,69.2%)、水停证(13/26,50%),组合证候阳虚水停证(13/26,50.0%)。阳虚水停型患者血浆AVP、尿液AQP-2浓度与气阴两虚型患者相比较明显升高(P<0.01);心功能Ⅳ级较心功能Ⅱ、Ⅲ级患者的血浆AVP、尿液AQP-2的浓度明显升高(P<0.01),心功能Ⅱ、Ⅲ级患者之间血浆AVP、尿液AQP-2的浓度无明显差别(P>0.05)。结论:随着心功能的恶化,慢性收缩性心力衰竭患者中医证型由气阴两虚向阳虚水停转化,血浆AVP、尿液AQP-2浓度逐渐升高。

Objective： To study the correlation between TCM syndrome types distribution and the expressions of AVP and AQP- 2 in different cardiac functional grades of 60 patients with chronic systolic heart failure. Methods： The clinical materials were collected from 60 patients with chronic systolic heart failure. The types of TCM syndrome were given descriptive and statistical analysis and AVP and AQP- 2 were measured by ELISA. Result： In CSHF patients with cardiac functional gradeⅡ,the most common syndrome type was syndrome of qi deficiency（ 30 /34,88. 2%） and the next was syndrome of yin deficiency（ 21 /34,61. 8%） and blood stasis（ 19 /34,55. 9%）. The common combined syndrome type was syndrome of qi- yin deficiency（ 18 /34,52. 9%）. In CSHF patients with cardiac functional grade Ⅲ and Ⅳ,the most common syndrome type was syndrome of yang deficiency（ 22 /26,84. 6%） and the next was syndrome of qi deficiency（ 18 /26,69. 2%） and water flood（ 13 /26,50%）. The common combined syndrome type was syndrome of yang deficiency and water flood（ 13 /26,50. 0%）. Comparing to patients with qi- yin deficiency,the expressions of AVP and AQP- 2 obviously up- regulated in patients with combining syndrome of yang deficiency and water flood（ P 0. 01）. Comparing to patients with cardiac functional gradeⅡ and Ⅲ,the expressions of AVP and AQP- 2 obviously up- regulated in patients with cardiac functional grade Ⅳ（ P 0. 01） and there was no difference between cardiac functional gradeⅡ andⅢ（ P 0. 05）. Conclusion： The syndrome types have a tendency of transforming gradually from syndrome of qi- yin deficiency to syndrome of yang deficiency and water flood and the expressions of AVP and AQP- 2 increase gradually too.