慢性肺原性心脏病患者血浆C型利尿利钠因子的变化

Changes of plasma C-type natriuretic peptide in patients with chronic cor pulmonale

目的:探讨慢性肺原性心脏病(肺心病)患者血浆C型利尿利钠因子(CNP)的变化及与动脉血氧分压pao2、肺动脉压的关系。方法:采用放射免疫分析法,检测30例肺心病患者急性加重期及缓解期血浆CNP的水平;经彩色多普勒测定右室射血前期时间(RVPEP)与肺动脉血流加速时间(AT)之比,以反映肺动脉压高低,并行动脉血气分析。对照组为20例健康体检者。结果:肺心病患者急性加重期和缓解期血浆CNP水平((73.38±33.29) n/L,(43.18±9.68) ng/L)明显高于对照组((16.89±9.16) ng/L)(P均<0.001),急性加重期高于缓解期(P<0.001);肺心病组急性加重期pao2((50.82±15.23)mmHg)明显低于缓解期((77.57±10.08)mmHg)(P<0.001),而急性加重期RVPEP/AT水平(1.64±0.36)高于缓解期(1.26±O.26)(P<0.001);肺心病组急性加重期和缓解期血浆CNP水平与pao2均呈显著负相关(r=-O.57,P<0.01;r=-0.79,P<0.001),而与RVPEP/AT均呈正相关(r=0.45,P<0.05;r=0.44,P<0.05)。结论:检测肺心病患者血浆CNP水平,可作为判断病情的一项指标。

Aim:To study the changes of plasma C-type natriuretic peptide(CNP) in patients with chronic cor pulmo-nale (CCP) ,and the relationship of CNP with Pao2 and pulmonary artery pressure. Methods: Radioimmunoassay (RIA) was used to measure the levels of plasma CNP in 30 patients with CCP at acute stage and stable stage respectively. The ratio of right ventricular pre-ejection period ( RVPEP) to the pulmonary flow acceleration time( AT) was determined with doppler echocardiography in 30 patients with CCP. Blood gas analysis was performed at the same time. Twenty healthy subjects were chosen as control group. Results:Plasma CNP levels at acute stage (73.38 ±33.29) ng/L and at stable stage (43. 18 ± 9.68) ng/L were obviously higher than those in control group (16.89 ±9. 16) ng/L(P <0.001) ;and that at acute stage was significantly higher than that at stable stage(P <0. 001) ;Pao2 at acute stage (50.82±15.23) mmHg was lower than that at stable stage ( 77. 57 ± 10. 08 ) mmHg ( P. < 0. 001 ) , while the levels of RVPEP/AT were on the contrary ( P < 0. 001 ) . Plasma CNP levels at both acute and stable stage had negative correlation with Pao2 (r = - 0. 57 , P < 0. 01 ; r = -0. 79,P<0.001) ,which had positive correlation with RVPEP/AT( r = 0. 45 ,P < 0. 05 ;r = 0. 44 ,P <0.05). Conclusions: The detection of CNP level can be regarded as an index for adjudging the state of CCP.