非对称二甲基精氨酸与心力衰竭的相关性研究

Correlation of asymmetric dimethylarginine and degree of heart failure

目的探讨血浆非对称二甲基精氨酸(asymmetric dimethylarginine,ADMA)浓度与心力衰竭及其程度的关系。方法选择45例心力衰竭住院患者,其中缺血性心肌病组25例,扩张型心肌病组20例,非心衰患者组30例。所有患者于入院后第二天早空腹采集静脉血15 m L,分别用高效液相色谱法(HPLC)检测ADMA,彩色多普勒三维超声测量左室射血分数。比较三组患者血浆ADMA浓度,ADMA浓度与心衰程度的关系。结果缺血性心肌病组血浆ADMA浓度(8.45±0.51 mg/L)及扩张型心肌病组血浆ADMA浓度(8.32±0.64)mg/L与对照组血浆ADMA浓度(7.13±0.54)mg/L有明显差异(P<0.001),但心衰组间血浆ADMA浓度无差异(P>0.05),血浆ADMA浓度与心衰程度明显相关(P<0.01)。结论心衰患者血浆ADMA浓度明显升高,心力衰竭的发生发展中起到一定作用。

Objective To evaluate the correlation of the level of asymmetric dimethylarginine （ADMA） in patients with congestive heart failure and the degree of heart failure. Methods Forty-five hospitalized patients with heart failure who reached the standard of Framingham were chosen, among them ischemic cardiomyopathy group with 25 cases, idiopathic dilated cardiomy- opathy group with 20 cases and control group with 30 cases. Venous blood 5 mL was acquired from all the patients on the next morning after admission. The plasma ADMA was measured by high performance liquid chromatography-mass spectrometry. Left ventricular ejection fraction （LVEF） was measured by two-dimensional echocardiography. Serum levels of ADMA in the three groups were compared and the correlation serum levels of ADMA with their LVEF were estimated. Results ADMA was significantly elevated in patients with heart failure compared with normal control （P 〈 0. 001 for both） , there was no difference between ischemic and idiopathic groups in ADMA （ P 〉 0.05 ） , and there was an inverse correlation between EF and serum ADMA level （ P 〈 0. 01 ）. Conclusion ADMA is significantly elevated in patients with heart failure and play a part in the occurrence and progress of heart failure.