心力衰竭患者血浆生长激素、脑利钠肽和肾上腺髓质素的变化

目的观察充血性心力衰竭（CHF）患者血清生长激素（GH）、脑利钠肽（BNP）和血浆肾上腺髓质素（ADM）的水平变化。方法心力衰竭组60例和非心力衰竭组（对照组）30例，分别用放射免疫法和酶联免疫法测定血浆ADM、血清BNP和GH的浓度，同时行心脏彩色多普勒超声测定左室舒张末内径（LVED）和左室射血分数（LVEF）。结果心力衰竭组GH和BNP的水平[（0．83±1．06）μg/L，（115．31±191．16）ng／L]高于对照组[（0．15±0．42）μg/L，（33．51±49．85）ng,／L]（t=2．689，t=2．765，P〈0．01）；心力衰竭组显效率和总有效率（39．7％，76．5％）高于对照组（32．3％，61．3％）（t=1．894，P〉0．05，t=2．265，P〈0．05）；BNP诊断心力衰竭的敏感度为89．3％，特异度为63．0％；GH诊断心力衰竭的灵敏度为85．7％，特异度为59．3％。BNP和GH联合使用，诊断心力衰竭的灵敏度为75．0％，特异度为74．0％。结论BNP与GH联合应用诊断心力衰竭好于二者单用。

Changes of growth hormone,brain natriuretic peptide and adrenomedullin in congestive heart failure

Objective To evaluate the changes of growth hormone(GH), brain natriuretic peptide(BNP) and adrenomedullin(ADM) in congestive heart failure patients. Methods The blood samples were obtained from 60 pa-tients with congestive heart failure(CHF) and 30 patients without CHF,and their serum/plasma levels of GH,BNP and ADM were measured by enzyme-labeled immunosorbentassay(ELISA) and radioimmunoassay. At the same time all the patients received colorful Doppler ultrasonocardio-gram to determine left ventricular end-dilation diameter (LVED) and left ventrieular ejection fraction(LVEF). Results The levels of BNP and GH in heart failure group were[(0.83±1.06) μg/L,(115.31±191.16) ng/L] higher than eontrol group[(0.15±0.42) μg/L, (33.51±49.85) ng/L] (t = 2.689, t = 2.765, P < 0.01); The efficiency and total efficiency in heart failure group was (39.7% ,76.5%) higher than control group (32.3%, 61.3%) (t = 1.894, P > 0.05, t = 2.265, P < 0.05); The sensitivities and specificities of BNP were 89.3% and 63.0%; The sensitivities and specificities of GH were 85.7% and 59.3%; The BNP combined with GH were 75.0% and 74.0%. Condusion The combination of GH and BNP is better than application alone in the diagnosis of CHF.