萘哌地尔对心力衰竭患者血浆降钙素基因相关肽及神经肽Y的影响

目的：研究心力衰竭患者血浆降钙素基因相关肽（CGRP）及神经肽Y（NPY）水平与心力衰竭严重程度、左室功能的关系及萘哌地尔对其影响。方法：用放射免疫法检测47例心力衰竭患者（CHF组）及18例健康体检者（对照组）血浆CGRP和NPY浓度。将CHF组随机分为常规治疗组24例和加用萘哌地尔组23例，1月后重复上述检查。结果：CHF组血浆CGRP浓度显著低于对照组（P〈0．05），随NYHA分级程度的加重而显著降低；血浆NPY浓度显著高于对照组（P〈0．05），随NYHA分级程度的加重而显著增加。血浆CGRP浓度与左室射血分数（LVEF）之间呈明显的正相关（rCGRP=0．39，P〈0．05），NPY浓度与LVEF之间呈明显的负相关（rNPY=-0．57，P〈0．01）。CHF组治疗后血浆CGRP显著升高（P〈0．05）和NPY浓度显著下降（P〈0．05），而萘哌地尔组治疗后比常规治疗后CGRP浓度升高及NPY浓度下降更为显著（P〈0．05）。结论：CHF患者血浆CGRP和NPY浓度均与心力衰竭严重程度有关。在常规治疗的基础上加用萘哌地尔治疗可进一步升高心力衰竭患者CGRP水平和降低NPY水平。

The Influence of Naftopidil on Plasma Calcitonin Gene Related Peptide and Neuropeptide Y Concentrations in Patients with Congestive Heart Failure

Objective: To study the relations of the plasma concentrations of calcitonin gene related peptide(CGRP)and neuropeptide Y(NPY)with the severity of heart failure and the left ventricular function in patients with congestive heart failure(CHF),and to study the effect of naftopidil on plasma concentrations of CGRP and NPY.Methods: Plasma CGRP and NPY concentrations of 47 patients with CHF(CHF group)and 18 healthy subjects(control group)were measured with radioimmunoassay.The patients were randomly chosen to receive naftopidil plus routine therapy(n=23)or routine therapy only(n=24)for 1 month. Results: 1)The plasma CGRP concentrations of patients were lower than those of normal controls(P<0.05)and NPY concentrations of patients were higher than those of normal controls(P<0.05).They also decreased or increased according to the severity of heart failure classified by NYHA's classification.CGRP had a significant positive correlation and NPY had a significant negative correlation with the left ventricular ejection fraction; 2)Both of the therapies were effective in increasing the levels of CGRP(P<0.05)and in decreasing the levels of NPY(P<0.05).The increase of CGRP level and the decrease of NPY level were more obvious in patients received naftopidil treatment(P<0.05).Conclusions: These findings suggest that CGRP and NPY could play an important role in the pathophysiological changes of CHF.Compared with routine therapy,naftopidil can further increase the CGRP level and decrease the NPY level in patients with congestive heart failure.