慢性心力衰竭病人血清肾上腺髓质素2、尿酸水平的变化及意义

目的：本研究探讨了新发现的小分子生物活性肽肾上腺髓质素2和尿酸在慢性心力衰竭（CHF）患者血清中的变化及可能机制。方法： 分为4组：正常对照组，心功能Ⅱ级组、Ⅲ级组、Ⅳ级组, 血清肾上腺髓质素2的观察每组20例，血清尿酸的观察每组40例，临床诊断采用美国纽约心脏病学会（N YHA） 心功能分级标准。采用酶联免疫吸附（ELISA）法测定血清肾上腺髓质素2，采用全自动生化分析仪测定尿酸。结果：（1） 心功能Ⅱ级、Ⅲ级、Ⅳ级组血清肾上腺髓质素2水平明显高于正常对照组（P〈0.01），心功能Ⅲ级组明显高于Ⅱ级组，心功能Ⅳ级组明显低于Ⅲ级组（P〈0.01），心功能Ⅱ级组与Ⅳ级组比较无显著性（P〉0.05）；（2）血清尿酸含量随着心功能级别的增高而逐渐升高。结论：肾上腺髓质素2可能参与了心力衰竭病理生理过程及对心功能的调节。尿酸含量能反映心力衰竭程度，可以作为心功能恶化的预测指标。

Changes and significance in serum adrenomedullin 2 and uric acid level in chronic heart failure

Objective：To explore the changes of adrenomedullin 2 （ the newly discovered small molecule bioactive peptide） and serum uric acid in the patients with chronic heart failure （CHF） and the possible mechanism.Methods：The patients were divided into four groups：control group and three groups of cardiac function grades Ⅱ,Ⅲ and Ⅳ The serum adrenomedullin 2 was observed in 20 cases of each group and the serum uric acid was observed in 40 cases of each group.The cardiac function was assessed according to the classification criteria of the New York Heart Association （NYHA）.The serum adrenomedullin 2 was measured by using enzyme-linked immunosorbent assay （ELISA） and the uric acid level by using automatic biochemical analyzer.Results：（1）The serum adrenomedullin 2 level in the cardiac function grade Ⅱ,Ⅲ and Ⅳgroups were significantly higher than that of the normal control group（P〈0.01）,obviously higher in the cardiac function grade Ⅲ group than that of the cardiac function gradeⅡgroup（P〈0.01）,but obviously lower in the cardiac function gradeⅣgroup than that of the cardiac function grade Ⅲ group（P〈0.01）,and there was no significant difference in it between the cardiac function grade II group and the cardiac function grade Ⅳgroup（P〉0.05）.（2） The serum uric acid level was gradually increased with cardiac function grade increasing.Conclusion：Adrenomedullin 2 may be involved in heart failure and the pathophysiological process and the regulation of cardiac function.Uric acid level is able to reflect heart failure degree and can be used as a predictor of deterioration of cardiac function.