慢性心力衰竭患者心功能分级或不同病因对神经内分泌水平及心功能状态的影响研究

目的探讨慢性心力衰竭（CHF）患者心功能分级或不同病因对神经内分泌水平及心功能状态的影响。方法将我院CHF患者168例根据心功能分级分为A组72例（Ⅲ级）、B组96例（Ⅳ级），并根据基础病因分为Ⅰ组76例（冠心病）、Ⅱ组52例（扩张性心肌病）、Ⅲ组40例（高血压病），对不同病因及心功能分级的肾素（PRA）、血管紧张素（AnglI）、醛固酮（ALD）、脑钠肽（BNP）水平及左室舒张末内径（LVEDD）、左室射血分数（LVEF）进行比较分析。结果B组PRA、AngⅡ、ALD、BNP、LVEDD及LvEF检测值显著高于B组，差异有统计学意义（P〈0．05）。Ⅰ、Ⅱ、Ⅲ三组上述检测值无统计学差异（P〉0．05）。结论CHF患者心功能越差，其神经内分泌水平被激活得更明显，从而促进了PRA、AngⅡ、ALD及BNP的释放，并加剧了心室重构现象。

Study on cardiac function classification or different etiology on neuroendocrine levels and heart function in patients withchronic heart failure

Objective To explore the effect of cardiac function classification or different etiology on neuroendocrine levels and heart function in Datients with chronic heart failure. Methods 168 patients with chronic heart failure of tour hospital were divided into group A（72 cases, grade m） and B（96 cases, grade Ⅳ） according to cardiac function classification, and were divided into group Ⅰ （coronary）, Ⅱ（dilated cardiomyopathy） and Ⅲ （hypertension） according to basic etiology. PRA, Ang Ⅱ, ALD, BNP, LVEDD, LVEF of different etiology and cardiac function classification were compared and analyzed. Results Level of PRA, Ang II , ALD, BNP, LVEDD and LVEF of group B were higher than group A significantly（P〈0.05）. Level of PRA, Ang II, ALD, BNP, LVEDD and LVEF among group Ⅰ, Ⅱ and Ⅲwere not significant（P〉0.05）. Conclusion The worse of cardiac function, the more obviously of neuroendocrine levels were activated, the phenomenon promotes the release of PRA, Ang II, ALD and BNP, adding to ventricular remodeling.