慢性肺原性心脏病患者血浆脑钠素和肾上腺髓质素测定

目的:研究慢性肺原性心脏病(肺心病)患者血浆脑钠素(BNP)和肾上腺髓质素(ADM)水平并探讨其临床意义。方法:用放射免疫分析法测定31例肺心病患者急性发作期(A组)和缓解期(B组)血浆BNP和ADM水平,并与动脉血氧分压(Pao2)进行相关分析。30例健康人为正常对照组(C组)。结果:A组血浆BNP和ADM高于B组和C组;B组血浆BNP和ADM高于C组,差异均有统计学意义(P<0.001)。A组血浆BNP和ADM与Pao2负相关(r=-O.67,P<0.01;r=-0.74,P<0.01),B组血浆ADM与Pao2负相关(r=-0.54,P<0.01),BNP与Pao2无显著相关性(P>0.05)。A组和B组血浆BNP和ADM水平呈正相关(r=0.70,P<0.01;r=0.59,P<0.01)。结论:血浆BNP和ADM水平升高共同参与了肺心病的病理生理过程,2者可能有代偿作用。

Detection of plasma brain natriuretic peptide levels and adrenomedullin levels in patients with chronic cor pulmonale

Aim: To explore the clinical significance of plasma brain natriuretic peptide ( BNP) and adrenomedullin ( ADM) levels in patients with chronic cor pulmonale. Methods;The plasma BNP and ADM levels in 31 patients with chronic cor pulmonale, who were allocated into cor pulmonale exacerbation stage (group A) and cor pulmonale remission stage (group B) , were detected by radioimmunoassay. Linear regression analysis was used to evaluate the correlations between Pao2 and BNP and ADM. A total of 30 healthy subjects served as normal control ( group C). Results:The plasma BNP and ADM levels in group A were significantly higher than those in group B and C. The plasma BNP and ADM levels in group B were significantly higher than those in group C. In group A, plasma BNP and ADM levels were both negatively correlated with Pao2 (r= -0.67, P<0.01; r= -0. 74, P <0. 01) and there were positive correlations between them (r= -0.70, P < 0. 01). In group B, plasma ADM levels were negatively correlated with Pao2 (r = -0.54, P < 0.01 ) and positively correlated with BNP ( r = 0. 59, P < 0. 01) , but there were no correlations between BNP and p,0 ( P > 0. 05 ) . Conclusion: The results suggest that BNP and ADM involved in the pathophysiological process of chronic cor pulmonale and may play an compensatory role in it.