心力衰竭患者血浆尾加压素Ⅱ与心钠素关系的研究

Correlation of Plasma Urotensin Ⅱ and Cardionatrin in Patients With Heart Failure

目的 :探讨不同程度心力衰竭患者血浆尾加压素Ⅱ、心钠素变化及其关系。方法 :放射免疫法检测 2 0例正常人 (对照组 )、45例心力衰竭患者 (心力衰竭组 ,心功能Ⅱ级 10例 ,Ⅲ级 15例 ,Ⅳ级2 0例 )血浆尾加压素Ⅱ和心钠素含量 ,超声心动图测定左心室射血分数、E峰与A峰比值 (E/A值 )。结果 :①对照组和心力衰竭组血浆尾加压素Ⅱ为 ( 4 3 5± 1 2 2 )pg/mlvs( 1 41± 1 0 9) pg/ml ,心钠素为 ( 4 1 82±6 0 9) pg/mlvs( 3 19 88± 3 0 2 1)pg/ml(P均 <0 0 0 1) ,均有极显著性差异 ;②心力衰竭组心力衰竭症状改善后 ,血浆尾加压素Ⅱ为 ( 1 90± 1 47) pg/ml,较治疗前 ( 1 41± 1 0 9) pg/ml升高 (P <0 0 5 ) ;治疗前后血浆尾加压素Ⅱ有正相关关系(r =0 5 63 ,P <0 0 0 1)。治疗后血浆心钠素为 ( 2 2 8 5 2± 2 2 0 1)pg/ml ,较治疗前明显降低 ,有显著正相关 (r =0 717,P<0 0 0 1) ;③血浆尾加压素Ⅱ含量减低、心钠素含量的升高与心力衰竭严重程度相平行 ;④血浆尾加压素Ⅱ含量与心钠素含量分别与心功能级别、左心室射血分数、E/A值有相关性。结论 :心力衰竭患者血浆心钠素含量升高伴有尾加压素Ⅱ含量下降 ,同时与心力衰竭程度平行 。

Objective: To investigate the changes and correlation of plasma urotensin Ⅱ(U Ⅱ) and cardionatrin in patients with congestive heart failure (CHF). Methods: Plasma U Ⅱ and cardionatrin were measured by radioimmunoassay in 45 patients with CHF and 20 control subjects.Left ventricular ejection fraction (LVEF) and the ratio of E/A were measured by echocardiography. Results: The plasma U Ⅱ level was significantly lower in patients with CHF than that in the control subjects〔(1.41±1.09)pg/ml vs (4.35±1.22)pg/ml, p<0.001〕. The decreased U Ⅱ and the increased cardionatrin were parallel with the severity of CHF. Plasma U Ⅱ and cardionatrin were respectively correlated with heart function, LVEF(r=0.540,p<0.001) and the ratio of E/A(r=0.539,p<0.001). LVEF and the ratio of E/A were inversely correlated with cardionatrin in the patients (r= -0.610,p<0.001;r=-0.342,p<0.01). There was a significant correlation between plasma levels of U Ⅱ and cardionatrin(r=-0.275,p<0.05). Plasma U Ⅱ level in the patients was higher after treatment than that before treatment. Conclusion: The decreased U Ⅱ and the increased cardionatrin were parallel with the severity of CHF. These results suggest that U Ⅱ may play a certain role in the pathophysiology of CHF.The plasma U Ⅱ level in patients with CHF may serve as an index of the severity of CHF.