水通道蛋白-2与利尿剂抵抗的心力衰竭相关性研究

目的:观察利尿剂抵抗的心力衰竭患者尿水通道蛋白-2(aquaporin-2,AQP2)治疗前后的变化情况,探讨心力衰竭患者发生利尿剂抵抗时尿AQP2变化的病理生理意义。方法:选择40例利尿剂抵抗患者,用ELISA法检测治疗前后尿AQP2值,同时记录钠排泄分数,左心室舒张器内径值,射血分数值。治疗前后做组间比较,各指标做相关性分析。结果:治疗后不同时段AQP2明显下降,钠排泄分数、射血分数(EF)与治疗前比较,明显高于治疗前,差异有统计学意义(P<0.01)。AQP2的变化与钠排泄分数,射血分数负相关(P<0.05)。与左心室舒张末期内径(LVED)无相关性(P>0.05)。结论:AQP2与心力衰竭严重程度的相关性高,可能参与了顽固性心力衰竭的利尿剂抵抗,有可能成为判断心力衰竭及其严重程度的新的生物学指标。

Correlation researchs of aquaporin -2 and heart failure with diuretic resistance

Objective To observe the changing conditions of urinary AQP2 before and after treat in heart failure＂ patients with diuretic resistance,and study the pathologic and physiologic meaning of the change of urinary AQP2 when diuretic resistance happened in them. Method ELISA was used to detect urinary AQP2 value before and after treatment in 40 cases of patients with diuretic resistance. At the same time, we recorded the fractional excretion of sodium,left ventricular internal diameter value and ejection fraction. Comparisons be- tween groups were tested before and after treatment, each index was correlatively analyzed. Results After treatment, AQP2 decreased signitl- candy in different periods, fractional excretion of sodium and ejection fraction were significantly higher than that before treatment （P 〈 0. O1 ）, the relativity about AQP2 and fractional excretion of sodium and EF was negative （P 〈 0. 05 ） and no correlation with left ventricular end diastolic diameter（ P 〉 0.05）. Conclusion AQP2 is significantly correlated with the severity of heart failure,it may be involved in diu- retic resistance of refractory heart failure, and is possible to be the new biology index to judge heart failure and its severity.