老年慢性心力衰竭患者血浆NT-proBNP、U-Ⅱ和尿AQP-2变化的研究

Levels of plasma NT-proBNP,Urotensin Ⅱ and Urine aquaporin 2 in elderly patients with chronic heart failure

目的探讨老年慢性充血性心力衰竭(CHF)患者治疗前后血浆氮末端脑钠肽前体(NT-Pro BNP)、尾加压素Ⅱ(U-Ⅱ)和尿水通道蛋白2(AQP-2)的变化及临床意义。方法将2012年1月至2014年1月在我院住院的老年CHF患者230例做为观察组,其中纽约心脏病协会(NYHA)心功能分级Ⅱ级62例、Ⅲ级76例、Ⅳ级92例,另设同期健康体检者100例作为对照组,检测治疗前后血浆NT-Pro BNP、U-Ⅱ和尿AQP-2的含量,比较治疗前后及2组间水平变化及其相互关系。结果老年CHF患者治疗前血浆NT-Pro BNP水平显著高于对照组,不同心功能等级患者NT-Pro BNP均较对照组增高,与CHF心功能等级呈正相关(P<0.01);治疗后血浆NT-Pro BNP水平较治疗前明显降低,差异有统计学意义(P<0.01)。老年CHF患者治疗前血浆U-Ⅱ水平明显低于对照组,不同心功能等级U-Ⅱ值均低于对照组,与CHF心功能等级呈负相关(P<0.01);治疗后与治疗前相比血浆U-Ⅱ水平明显升高(P<0.01)。老年CHF患者治疗前后尿AQP-2水平及变化趋势与血浆NT-Pro BNP变化趋势一致(P<0.01)。血浆NT-Pro BNP水平与血浆U-Ⅱ水平呈负相关,与尿AQP-2呈正相关(P<0.01)。结论血浆NTPro BNP、U-Ⅱ和尿AQP-2与心功能等级相关,在CHF的发生发展中发挥着重要作用。

Objective To investigate the levels of plasma N-terminal pro-brain natriuretic peptide（ NT-pro BNP）,urotensin Ⅱ（ U-Ⅱ） and urine aquaporin 2（ AQP-2） of elderly patients with chronic heart failure（ CHF） before and after treatment. Methods 230 hospitalized CHF patients from January 2012 to January 2014 in Nanjing General Hospital of Nanjing Military Region were analyzed. According to classification of function capacity of the NYHA,the cardiac functional grading of the patients were grade Ⅱ（ 62 cases）,gradeⅢ（ 76 cases） and grade Ⅳ（ 92 cases）. Meanwhile,100 healthy controls were enrolled. The levels of plasma NT-pro BNP,U-Ⅱ and urine AQP-2 were tested and compared. Results Before treatment,compared with the healthy control,plasma NT-Pro BNP in CHF patients was significantly higher（ P〈0. 01）. NT-Pro BNP significantly increased in different CHF grades,and were positively correlated with heart function classification（ P〈0. 01）. After treatment,plasma NT-Pro BNP level was significantly decreased（ P〈0. 01）. Plasma U-Ⅱ in CHF patients was significantly lower than that in healthy controls and was negatively correlated with heart function classification（ P〈0. 01）. After treatment,the plasma U-Ⅱ of the CHF patients was significantly increased（ P〈0. 01）. Urine AQP-2 showed the same trend with plasma NT-Pro BNP in the patients. Plasma NT-Pro BNP was negatively correlated with U-Ⅱ and positively correlated with urine AQP-2（ P〈0. 01）. Conclusions Plasma NT-pro BNP,U-Ⅱ and urine AQP-2 are corresponding with heart function classification,which may play an important role in the development of CHF.