心包积液中几种多肽类物质的观察

A Study on Polypeptide Substances in Hydropericardium

目的 :为探讨C型利钠多肽 (CNP)、神经肽Y(NPY)、降钙素基因相关肽 (CGRP)在心包积液时的变化及其作用。方法 :用放射免疫分析测定心包积液患者的血液和心包积液中的CNP、NPY、CGRP水平。并与正常对照组的血液中的水平进行比较。结果 :血液和心包积液中的CNP显著高于对照组 (p <0 0 1) ,血液中NPY和CGRP则与对照组无显著性差异 (p >0 0 5 ) ,心包积液中NPY水平显著低于血液中 (p <0 0 5 ) ,心包积液中的CGRP水平则显著高于血液中 (p <0 0 1)。心包积液的量与心包积液中CNP、CGRP呈正相关 (r=0 71,p <0 0 1,r=0 5 7,p <0 0 1)与NPY呈负相关 (r=- 0 6 7,p <0 0 1) ,心包积液中的CNP、NPY和CGRP与其血液中的浓度间无显著相关性 (p >0 0 5 )。结论 :心包积液中有一定量的CNP、NPY和CGRP ,很可能由心包分泌。心包积液患者体内的CNP、NPY和CGRP的改变可能对心包积液的病理生理状况起到重要的调节作用。

Objective To study the changes of C-type natriuretic peptide (CNP), neuropeptide Y (NPY) and calcitonin gene-related peptide (CGRP) contents in blood and pericardial effusion fluid of patients with hydropericardium as well as the clinical meanings. Methods CNP, NPY and CGRP contents in blood and pericardial effusion fluid were measured with RIA in 36 patients with hydropericardium and 30 controls (blood only). Results Blood CNP contents in the patients were significantly higher than those in the controls ( p <0 01), however, blood contents of NPY and CGRP in the two groups were not much different. In patients with hydropericandium, the blood and effusion fluid contents of CNP were about the same but the NPY content in effusion fluid was significantly lower than that in blood ( p <0 05) and the CGRP content greatly higher ( p <0 01). The volume of the effusion fluid was positively correlated to the fluid CNP, CGRP contents ( r=0 71,p<0 01;r=0 57,p<0 01 ) and negatively correlated to NPY content ( r=-0 67,p <0 01). The fluid contents of the peptides were not correlated to the levels in blood ( p >0 05). Conclusion Pericardium may secret a certain quantity of those peptides. Changes in contents of those peptides in patients with hydropericardium may play an important role of modulation in the pathophysiology.