慢性肺原性心脏病患者血浆精氨酸加压素、心钠素及肺动脉压测定  

Detection of plasma arginine vasopressin,artrial natriuretic peptide and pulmonary artery pressure in patients with chronic cor pulmonale

作　　者：侯宇虹[1] 唐显春[2] 潘金兵[3] 李莉[1] 王苏[1] 张国俊[4] 邢丽华[4] 孙培宗[4] 王书钧[4] 

机构地区：[1]郑州大学第一附属医院急诊科,郑州450052 [2]潢川县人民医院急诊科,潢川465150 [3]河南省人民医院呼吸内科,郑州450003 [4]郑州大学第一附属医院呼吸内科,郑州450052

出　　处：《郑州大学学报（医学版）》2008年第5期974-976,共3页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:观察慢性肺原性心脏病患者急性加重期和缓解期血浆精氨酸加压素(AVP)及心钠素(ANP)的变化及其与肺动脉压的关系。方法:慢性肺心病患者(肺心病组)33例,分别于急性发作期和缓解期应用放射免疫法测定血浆AVP和ANP水平,同时选择30例健康志愿者为对照。肺心病患者经彩色多普勒测定右室射血前期时间/加速时间(RVPEP/AT)以估测肺动脉压。结果:①正常对照组、肺心病组缓解期与急性加重期AVP((4.62±4.14)ng/L,(53.98±26.18)ng/L,(138.28±57.18)ng/L)与ANP((67.00±63.88)ng/L,(298.50±141.06)ng/L,(627.89±177.77)ng/L)呈升高趋势,3组间比较,差异有统计学意义(F分别为92.85,127.40,P均<0.05)。肺心病组缓解期RVPEP/AT低于急性加重期((1.24±0.26)vs(1.63±0.36),t=8.86,P<0.05)。②肺心病急性加重期和缓解期AVP、ANP与RVPEP/AT以及AVP与ANP均有相关性,P均<0.05。结论:AVP、ANP均可能参与肺动脉压的调节,检测血浆AVP或ANP水平可用于评估肺心病的严重程度和预后。Aim： To explore the changes of arginine vasopressin （AVP） and artrial natriuretie peptide （ANP） of chronic cor pulmonale（CCP） patients and the relationship of those with pulmonary artery pressure. Methods：CCP group consisted of 33 patients, who were detected each index in both acute stage and stable stage respectively. Control group consisted of 30 healthy subjects. The levels of plasma AVP and ANP were measured with radioimmunoassay （RIA） , and the RVPEP/AT was determined with doppler echocardiograph in 33 patients with CCP to estimate pulmonary artery pressure. Results： Plasma AVP and ANP levels in control group, stable stage and acute stage groups were in elevated tendency, and there were significant differences among the three groups; the levels of RVPEP/AT in stable stage group were lower than those in acute stage group （P 〈0.05 ）. In CCP group, AVP and ANP had correlations with the RVPEP/AT in acute and stable stage, and so did with AVP and ANP （ P 〈0.05 for each）. Conclusion ： Both AVP and ANP may participate in the regulation of pulmonary pressrue, and might affect each other. The detection of AVP or ANP levels might be used for esti- mating the extent and prognosis of CCP.

关 键 词：精氨酸加压素 心钠素 肺动脉高压 肺原性心脏病 

分 类 号：R541.5[医药卫生—心血管疾病]