血钠水平对收缩性心力衰竭患者肾素-血管紧张素-醛固酮系统、血浆脑钠肽水平的影响研究  

Impact of Blood Sodium Level on Renin-angiotensin-aldosterone System and Plasma BNP Level of Patients with Systolic Heart Failure

作　　者：宁小康 陈学彬 贾恩志[2] 

机构地区：[1]陕西中医药大学附属医院心血管科,陕西省咸阳市712000 [2]南京医科大学第一附属医院心血管内科

出　　处：《实用心脑肺血管病杂志》2016年第11期7-10,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：国家自然科学基金(30971257)

摘　　要：目的探讨血钠水平对收缩性心力衰竭患者肾素-血管紧张素-醛固酮系统(RAAS)、血浆脑钠肽水平的影响。方法选取陕西中医药大学附属医院2013年5月—2016年5月收治的收缩性心力衰竭患者300例,按照血钠水平分为低钠组(血钠水平<135 mmol/L,n=150)和正常组(血钠水平≥135 mmol/L,n=150)。比较两组患者血浆肾素、血管紧张素、醛固酮、脑钠肽水平,比较不同心功能分级患者血浆肾素、血管紧张素、醛固酮、脑钠肽及血钠水平,并分析血钠水平与血浆肾素、血管紧张素、醛固酮、脑钠肽水平的相关性。结果低钠组患者血浆肾素、血管紧张素、醛固酮、脑钠肽水平高于正常组(P<0.05)。心功能分级Ⅳ患者血浆肾素、血管紧张素、醛固酮、脑钠肽水平高于心功能分级Ⅱ级、Ⅲ级患者,血钠水平低于心功能分级Ⅱ级、Ⅲ级患者(P<0.05);心功能分级Ⅲ级患者血浆肾素、血管紧张素、醛固酮、脑钠肽水平高于心功能分级Ⅱ级患者,血钠水平低于心功能分级Ⅱ级患者(P<0.05)。直线相关性分析结果显示,血钠水平与收缩性心力衰竭患者血浆肾素(r=-0.425)、血管紧张素(r=-0.378)、醛固酮(r=-0.466)、脑钠肽(r=-0.621)水平呈负相关(P<0.05)。结论血钠水平降低会导致收缩性心力衰竭患者RAAS激活、血浆脑钠肽水平升高,进而加重患者心功能损伤。Objective To investigate the impact of blood sodium level on renin - angiotensin - aldosterone system （RAAS） and plasma BNP level of patients with systolic heart failure. Methods A total of 300 patients with systolic heart failure were selected in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from May 2013 to May 2016, and they were divided into A group （ with blood sodium level less than 135 mmol/L） and B group （ with blood sodium level equal or over 135 mmol/L） according to the blood sodium level, each of 150 cases. Plasma levels of renin, angiotensin, aldosterone and BNP were compared between the two groups, plasma levels of renin, angiotensin, aldosterone and BNP, and blood sodium level were compared in patients with different cardiac functional grading, correlations between blood sodium level and serum level of renin, of angiotensin, of aldosterone, of BNP were analyzed. Results Plasma levels of renin, angiotensin, aldosterone and BNP of A group were statistically significantly higher than those of B group （P 〈 0. 05）. Plasma levels of renin, angiotensin, aldosterone and BNP of patients with Ⅳ - grade cardiac function were statistically significantly higher than those of patients with Ⅱ - grade cardiac function or Ⅲ - grade cardiac function, while blood sodium level of patients with Ⅳ - grade cardiac function was statistically significantly lower than that of patients with Ⅱ - grade cardiac function or Ⅲ - grade cardiac function, respectively （ P 〈 0. 05 ）. Plasma levels of renin, angiotensin, aldosterone and BNP of patients with Ⅲ - grade cardiac function were statistically significantly higher than those of patients with Ⅱ - grade cardiac function, while blood sodium level of patients with Ⅲ- grade cardiac function was statistically significantly lower than that of patients with Ⅱ - grade cardiac function （ P 〈 0.05 ）. Linear correlation analysis results showed that, blood sodium level was negatively correlated with plasma le

关 键 词：心力衰竭 收缩性 钠 肾素-血管紧张素-醛固酮系统 利钠肽 脑 

分 类 号：R541.6[医药卫生—心血管疾病]