神经型一氧化氮合酶在慢性心力衰竭患者血浆中的变化及其作用  

The changes and roles of neuronal nitric oxide synthase in the plasma of patients with chronic heart failure

作　　者：丁娜 刘文博[1] 崔兰[1] 林梅花 金春子 

机构地区：[1]延边大学附属医院心内科,吉林省延吉市133000 [2]延边大学附属医院中心实验室,吉林省延吉市133000

出　　处：《中国心血管病研究》2017年第9期787-791,I0002,共6页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金（项目编号：81460039）：吉林省教育厅科研基金（项目编号：2016-276）;吉林省科技厅青年科研基金（项目编号：20140520024JH）吉林省卫生厅青年科研基金（项目编号：2014Q043）

摘　　要：目的 探讨神经型一氧化氮合酶（nNOS）在慢性心力衰竭（CHF）患者血浆中的变化及其作用.方法 入选2015年11月至2016年4月就诊于延边大学附属医院的失代偿CHF患者共计234例,根据左室射血分数（LVEF）值不同分成3个组：A组（LVEF 20％～29％）、B组（LVEF 30％～49％）、C组（LVEF≥50％）;另根据年龄分为中老年组和老年组,均进行nNOS浓度比较.结果 ①三组患者血浆nNOS浓度比较,差异均有统计学意义[（87.7±6.6）U/L比（178.0±11.5）U/L比（142.6±8.8）U/L,P＜0.05],其中A组患者血浆nNOS浓度明显低于B组[（87.7±6.6）U/L比（178.0±11.5）U/L,P＜0.01];C组患者血浆nNOS浓度略低于B组[（178.0±11.5）U/L比（142.6±8.8）U/L,P＜0.05];A组患者血浆nNOS浓度低于C组[（87.7±6.6）U/L比（142.6±8.8）U/L,P＜0.05].②三组患者E峰值比较,差异均有统计学意义[（0.7±0.05）m/s比（0.9±0.03）m/s比（0.8±0.03）m/s,P＜0.05],其中A组患者E峰值低于B组[（0.7±0.05）m/s比（0.9±0.03）m/s,P＜0.05];C组患者E峰值略低于B组（0.8±0.03）m/s比（0.9±0.03）m/s,P＜0.05）;A组患者E峰值略低于C组[（0.7±0.05）m/s比（0.8±0.03）m/s,P＜0.05].③中老年组与老年组比较,血浆nNOS浓度未见统计学差异（P＞0.05）.④用Spearman相关分析对血浆nNOS浓度与抗心衰药物之间的关系进行分析,血浆nNOS浓度与ACEI类、ARB类、地高辛和β-blocker呈正相关.结论 心力衰竭患者增加的神经型一氧化氮合酶是通过对E峰的调节来保护心功能的.Objective To investigate the changes and roles of nNOS in the plasma of patients with chronic heart failure （CHF）.Methods 234 consecutive patients with decomposition CHF who were admitted to Yanbian University Hospital from November 2015 to April 2016 were enrolled.According to the left ventricular ejection fraction（LVEF） values,the patients were divided into 3 groups：group A（EF：20%-29%）,group B（EF：30%-49%）,group C （EF：≥ 50%）.In addition,nNOS concentration was compared between the quinquagenarian group and the elderly group.Results （1）The nNOS concentration of plasma in three groups were statistically significant [（87.7±6.6）U/L vs （178.0± 11.5）U/L vs （142.6±8.8）U/L,P〈0.05],among them,plasma nNOS levels in group A were significantly lower than those in group B[（87.7±6.6）U/L vs （178.0±11.5）U/L,P〈0.01];plasma nNOS levels in group C were lower than those in group B[（178.0±11.5）U/L vs （142.6±8.8）U/L,P〈0.05];plasma nNOS levels in group A were lower than those in group C[（87.7±6.6）U/L vs （142.6±8.8）U/L,P〈0.05].（2）There were significant difference in E peak among the three groups[（0.7±0.05）m/s vs （0.9±0.03）m/s vs （0.8±0.03）m/s,P〈0.05],among them,the value of E peak in group A was lower than that in group B[（0.7±0.05）m/s vs （0.9±0.03）m/s,P〈0.05];the value of E peak in group C was lower than that in group B[（0.8±0.03）m/s vs （0.9±0.03）m/s,P〈0.05];the value of E peak in group A was lower than that in group C [（0.7±0.05）m/s vs （0.8 ±0.03）m/s,P〈0.05].（3）Comparison the nNOS concentration of plasma with between the quinquagenarian group and the elderly group.There was no significant difference （P〉0.05）.（4）The nNOS concentration of plasma was positively correlated with ACEI,ARB,digoxin and β-blocker.Conclusion The increase of nNOS in patients with heart failure is to protect the cardiac function through the regulation of E peak.

关 键 词：神经型一氧化氮合酶 慢性心力衰竭 左室射血分数 

分 类 号：R541.6[医药卫生—心血管疾病]