测定慢性心力衰竭患者血醛固酮的临床意义

Clinical significance measuring blood aldosterone in chronic heart failure

目的:探讨慢性心力衰竭(CHF)患者血醛固酮(ALD)、睾酮以及雌二醇水平的临床意义。方法:纳入CHF患者174例作为CHF组(其中NYHAⅡ级19例、Ⅲ级36例、Ⅳ级32例),同时纳入160例健康体检者作为健康对照组。CHF组又根据治疗结果分为住院期间死亡组(8例)和好转出院组(79例);检测各组ALD、睾酮以及雌二醇水平并进行比较。结果:与健康对照组比较,CHF组ALD[(78.75±28.53)ng/L比(161.52±35.94)ng/L]水平明显升高(P<0.01),且随着心功能等级的增加而明显升高(P<0.05或<0.01),睾酮[(5.54±0.56)μg/L比(5.19±0.52)μg/L]、雌二醇[(227.26±32.37)ng/L比(216.57±31.16)ng/L]水平明显降低(P均<0.05),且随着心功能等级的增加而明显降低(P<0.05或<0.01);Pearson相关性分析显示,ALD水平与睾酮、雌二醇水平呈显著负相关(r=-0.523、-0.537,P<0.05或<0.01);与好转出院组比较,住院期间死亡者ALD[(156.76±30.64)ng/L比(216.25±44.59)ng/L]明显升高,睾酮[(7.21±0.66)μg/L比(4.94±0.49)μg/L]、雌二醇[(222.54±24.57)ng/L比(153.05±21.39)ng/L]水平明显降低(P<0.05或<0.01)。结论:血醛固酮水平可作为评估慢性心衰患者心功能以及预后的重要指标。

Objective：To explore clinical significance measuring blood aldosterone（ALD）,testosterone（T）and estradiol（E2）levels in chronic heart failure（CHF）.Methods：A total of 87 CHF patients were enrolled as CHF group,including 19 cases of NYHA class II,36 cases of class III and 32 cases of class IV.Another 80 healthy subjects were selected as healthy control group.According to therapeutic outcomes,CHF group was further divided into death group（n=8）during hospitalization and improved discharge group（n=79）;levels of ALD,T and E2 were measured and compared among all groups.Results：Compared with healthy control group,there was significant rise in ALD level[（78.75±28.53）ng/L vs.（161.52±35.94）ng/L]（P〈0.01）,and it significantly rose along with NYHA class increased（P〈0.05or0.01）,and significant reductions in levels of T [（5.54±0.56）μg/L vs.（5.19±0.52）μg/L]and E2[（227.26±32.37）ng/L vs.（216.57±31.16）ng/L]in CHF group（P〈0.05both）,and it significantly reduced along with NYHA class increased（P〈0.05or0.01）;Pearson correlation analysis indicated that ALD level was significantly negatively correlated with T and E2levels（r=-0.523,-0.537,P〈0.05or0.01）;compared with improved discharge group,there was significant rise in ALD level[（156.76±30.64）ng/L vs.（216.25±44.59）ng/L],and significant reductions in levels of T [（7.21±0.66）μg/L vs.（4.94±0.49）μg/L]and E2 [（222.54±24.57）ng/L vs.（153.05±21.39）ng/L]in death group,P〈0.05or0.01.Conclusion：Blood aldosterone level can be regarded as an important index assessing heart function and prognosis of CHF patients.