慢性心衰患者甲状旁腺激素与RAAS活性的相关性

Correlation between parathyroid hormone and renin-angiotensin-aldosterone system(RAAS) activity in patients with chronic heart failure(CHF)

目的探讨慢性心力衰竭(CHF)患者血清甲状旁腺激素(PTH)与肾素-血管紧张素-醛固酮系统(RAAS)活性的相关性及意义。方法选择东风总医院住院的CHF患者71例为心力衰竭组,根据纽约心脏病协会(NYHA)制定的心功能分级标准:Ⅱ级患者21例,Ⅲ级患者26例,Ⅳ级患者24例。同时选择我院同期健康体检者50例,作为健康对照组。测定血清PTH、血清醛固酮(ALD)、血浆血管紧张素Ⅱ(Ang-Ⅱ)、血浆肾素(PRA)及血浆脑钠肽(BNP)浓度并分析其相关性。结果 CHF患者PTH、ALD、Ang-Ⅱ、PRA及BNP浓度均明显高于对照组,差异有统计学意义(P<0.01)。心功能Ⅳ级、Ⅲ级、Ⅱ级的CHF患者PTH、ALD、Ang-Ⅱ、PRA及BNP浓度比较,差异有统计学意义(P<0.01);其中心功能Ⅳ级、Ⅲ级患者PTH、ALD、Ang-Ⅱ、PRA及BNP浓度均高于心功能Ⅱ级患者,心功能Ⅳ级患者PTH、ALD、Ang-Ⅱ、PRA及BNP浓度均高于心功能Ⅲ级患者,差异有统计学意义(P<0.01或P<0.05);且各指标浓度随心功能分级的增加而逐渐增高。Pearson相关分析:CHF患者PTH水平与RAAS活性及心功能分级的严重程度呈正相关。结论 CHF患者PTH水平与RAAS活性及心功能分级严重程度呈正相关,且其浓度随着心功能分级的增加而逐渐增高,两者相互作用,共同参与慢性心力衰竭的致病机制。

Objective To investigate relationships between parathyroid hormone and renin- angiotensin- aldosteronesystem（RAAS） activity in patients with chronic heart failure（CHF）. Methods Seventy- one CHF cases in in DongfengHospita were selected and according to New York Heart Association（NYHA） developed cardiac function grading criteria,21 patients were divided into gradeⅡ, 26 patients in grade III,24 patients in grade IV and 50 healthy controls. The levels ofserum PTH,ALD,Ang-Ⅱ,PRA and BNP in all the patients were determined and the correlation was analyzed. Results Thelevels of serum PTH,ALD,Ang-Ⅱ,PRA and BNP in CHF patients were significantly higher than those of the healthy controlgroup（ P〈0.01）. The levels of serum PTH,ALD,Ang-Ⅱ,PRA and BNP in class IV, grade III and Ⅱ patients were significantlydifferent（ P〈0.01）;The levels of serum PTH,ALD,Ang- Ⅱ,PRA and BNP in both grade IV and III patients significantlyelevated comparing with class Ⅱ patients.The levels of serum PTH,ALD,Ang- Ⅱ,PRA and BNP in grade IV patientssignificantly elevated comparing with class III patients（P〈0.01 or P〈0.05）.Each index of cardiac function classificationconcentration aggravated gradually increase. Pearson correlation analysis：PTH level is positively correlated with RAAS activityand the severity of cardiac function classification in CHF patients. Conclusion PTH level is positively correlated withRAAS activity and the severity of cardiac function classification in CHF patients, and the concentration of heart failure severitygradually increased,they may interact and influence each other in the pathogenic mechanism of chronic heart failure.