神经内分泌激素水平对评估射血分数正常的老年心力衰竭患者心功能的价值  

Evaluation of neuroendocrine hormones in elder patients of heart failure with normal ejection fraction

作　　者：罗世红[1] 贾玲[1] 

机构地区：[1]河南省郑州大学第一附属医院,河南郑州450052

出　　处：《中国现代医学杂志》2010年第11期1678-1680,共3页China Journal of Modern Medicine

摘　　要：目的探讨射血分数正常、不同心功能分级的老年心力衰竭患者神经内分泌激素水平的变化及其与心衰程度分级的相关性。方法测定40例射血分数正常的老年心力衰竭患者(心衰组)和30例心功能正常的老年患者(对照组)血浆脑钠肽(BNP)、肾素、血管紧张素II及醛固酮的水平,用彩色多普勒超声心动图仪测定各组左室射血分数。结果心衰组血浆BNP水平显著高于对照组(P<0.01),且随着NYHA心功能分级程度的加重BNP水平也显著增高(P<0.01)。心衰组肾素、血管紧张素II及醛固酮的水平较对照组高,但两者之间无统计学意义(P>0.05),在心衰组各级心功能水平之间也无明显规律。结论射血分数正常的老年心力衰竭患者血浆BNP水平随心衰严重程度的加重而显著升高,测定血浆BNP水平对射血分数正常的老年心力衰竭的诊断及心功能水平的评价方面有重要参考价值,而肾素、血管紧张素II及醛固酮的水平的测定意义在此方面的意义不大。[Objective]To study the changes in concentration of neuroendocrine hormones in elder patients of heart failure with normal ejection fraction （HF-NEF）.[Methods]The concentration of plasma brain natriuretic peptide （BNP）, rennin, angiotensin II, aldosterone and measured left ventricular ejection fraction （LVEF） were compared by color Doppler echocardiograph of the 40 elder HF-NEF patients with those of 30 elder controls. [Results]The concentration of BNP in HF-NEF group was significantly higher than that of control group and correlated well with the severity of cardiac functional grading classified by NYHA （P 0.01）. The levels of rennin, angiotensin II, and aldosterone in HF-NEF group were higher than control group, but did not reach statistical significance. Moreover, the levels of rennin, angiotensin II, and aldosterone in patients did not correlate with different heart functional levels elder HF-NEF patients.[Conclusion]The concentration of plasma BNP in elder HF-NEF patients increases with the aggravation of heart failure and may play an important role in diagnosis of elder HF-NEF patients and evaluation of the severity of cardiac function. However, the plasma concentration of rennin, angiotensin II, and aldosterone are of little help in this aspect.

关 键 词：射血分数正常的心力衰竭 神经内分泌激素 血浆脑钠肽 

分 类 号：R541.61[医药卫生—心血管疾病]