慢性心功能衰竭患者血浆尾加压素Ⅱ、内皮素和肾上腺髓质素的变化  

The Changes of UrotensinⅡ, Endothelin and Adrenomedullin in Chronic Heart Failure

作　　者：富路[1] 戴颖楠[1] 朱立群[1] 万晓京[2] 曹君娴[1] 韩颖[1] 谢荣盛[1] 

机构地区：[1]哈尔滨医科大学附属第一医院,黑龙江省哈尔滨市150001 [2]哈尔滨医科大学附属第四医院,黑龙江省哈尔滨市150001

出　　处：《中国动脉硬化杂志》2007年第3期201-204,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的研究尾加压素Ⅱ、内皮素和肾上腺髓质素在慢性心功能衰竭患者血浆中含量的变化并探讨其临床意义。方法采用放射免疫法测定40例正常人、42例心功能衰竭患者治疗前后的血浆尾加压素Ⅱ、内皮素和肾上腺髓质素的含量,同时采用彩色多普勒超声心动图测定左心室射血分数和左心室重量指数。结果心功能衰竭患者血浆尾加压素Ⅱ水平明显低于正常对照组(1.53±0.74pmol/L比4.78±1.57pmol/L,P<0.01),治疗后与治疗前相比尾加压素Ⅱ水平明显升高(3.63±1.09pmol/L比1.53±0.74pmol/L,P<0.01)。血浆尾加压素Ⅱ水平与心功能级别负相关(r=-0.77,P<0.01),与左心室射血分数正相关(r=0.80,P<0.01),与左心室重量指数负相关(r=-0.39,P=0.01)。心功能衰竭患者血浆内皮素水平明显高于正常对照组(51.83±11.38ng/L比43.69±4.76ng/L,P<0.05),治疗后轻度升高,较治疗前差异无显著性(P>0.05)。心功能衰竭患者血浆肾上腺髓质素水平明显高于正常对照组(26.14±9.46ng/L比19.10±4.74ng/L,P<0.05),治疗后降低,较治疗前没有统计学差异(P>0.05)。结论多种舒、缩血管活性肽共同参与心功能衰竭的病理生理过程。尾加压素Ⅱ的含量可能作为评价心室重构及心功能衰竭严重程度的指标,它有利于心功能衰竭的诊断,并可能成为心力衰竭治疗的一个新的靶点。Aim To observe the changes of plasma Urotensin-Ⅱ (UⅡ), Endothelial (ET) and Adrenomedullin (ADM) levels in chronic heart failure (CHF) and to investgate their clinical implications. Methods Plasma UⅡ, ET and ADM levels of 42 patients with CHF and 40 control subjects were measured by radioimmunoassay. In all the subjects, the left ventricular ejection fraction and the left ventricular mass index were measured by echocardiography. Results The plasma UⅡ levels were significantly lower in patients with CHF in comparison with that in control subjects (1.53±0.74 pmol/L vs 4.78±1.57 pmol/L, P<0.01). The plasma UⅡ levels after treatment were higher than before (3.63±1.09 pmol/L vs 1.53±0.74 pmol/L, P<0.01). A significant correlation of plasma UⅡ levels with the classes of cardiac function in CHF (r=-0.77,P<0.01), LVEF(r=0.80,P<0.01) and LVMI (r=-0.39, P=0.01) was observed. The plasma ET levels in patients were significantly higher than that in controls (51.83±11.38 ng/L vs 43.69±4.76 ng/L, P<0.05). The levels of plasma ET after treatment were higher than before (P>0.05). The plasma ADM levels in patients were significantly higher than that in controls (26.14±9.46 ng/L vs 19.10±4.74 ng/L, P<0.05). After therapeutic interventions, the plasma ADM levels were lower than before (P>0.05). Conclusions Vasoactive peptide might play a role in the pathophysiological process of CHF. UⅡ can evaluate left ventricular reconstitution and the severity of CHF. UⅡ may be of use in the diagnosis of heart failure. It may become a new target for the treatment of CHF.

关 键 词：内科学 尾加压素Ⅱ 心功能衰竭 左心室重量指数 心室重构 内皮素 肾上腺髓质素 

分 类 号：R543.1[医药卫生—心血管疾病]