慢性充血性心力衰竭患者神经内分泌变化的意义

本文应用放射免疫分析法测定48例心脏病伴各级心功能患者血浆ANF、EDLS、PRA、ATⅡ浓度,并与28例正常人作比较。结果表明:CHF患者血浆ANF、EDLS、PRA、ATⅡ浓度均明显高于正常对照组,ANF、EDLS浓度随心衰严重程度加重而增加。血浆ANF、EDLS、ATⅡ浓度与血钠浓度呈明显负相关(r=-0.4253,p<0.01;r=-0.7886,P<0.001;r=-0.4331,P<0.01),ANF与EDLS浓度呈明显正相关(r=0.8408,P<0.001)。心衰纠正后,血浆ANF、EDLS、PRA、ATⅡ浓度明显降低,在原发病因中,以扩张型心肌病血浆ANF、EDLS含量最高,其次为风心病、冠心病,提示ANF、EDLS、RAS在CHF发生发展过程中起一定作用。监测血浆ANF、EDLS、PRA、ATⅡ不仅可以作为判断病情严重程度的参考指标,而且也可以作为判断疗效及指导用药的依据。

CLINIC SIGNIFICANCE OF CHAGES OF NEUROENDOCRIN ACTIVITY IN PATIENTS WITH CHRONIC CONGESTIVE HEARTFAILURE

The concentrations of plasma ANF, EDLS, PRA and ATⅡ were measured with radioimmunoassary in 48 patients with heart diseases (cardiac function Ⅰ-Ⅳ, NYHA) and 28 normal subjects. The results showed that: the plasma concentrations of ANF, EDLS, PRA and ATⅡ were significantly higher in patients with congestive heart failure (CHF) than those in normal subjects (P<0.001; P<0.001; P<0.05; P<0.05 espectively). The concentrations of plasma ANF and EDLS in severe CHF patients (cardiac function Ⅲ, Ⅳ, MYHA) were significantly higher than those in the mild ones (cardiac function Ⅱ, MYHA ). The plasma concentrations of ANF, EDLS, PRA and ATⅡ were significantly declined after the heart failure was properly treated. Plasma ANF and EDLS concentrations in patients with congestive cardiomypathy were the highest and in patients with coronary heart disease the lowest.