一氧化氮、内皮素-1、血栓素B2与慢性心力衰竭患者脑钠肽水平的相关性  

Association of nitric oxide,endothelin-1,thromboxane B2 with brain natriuretic peptide level in patients with chronic heart failure

作　　者：朱洪新 金齐颖 任政 苏文静 蒋莹 ZHU Hong-xin;JIN Qi-ying;REN Zheng;SU Wen-jing;JIANG Ying(Department of Cardiology,the Second Hospital of Qinhuangdao,Qinhuangdao,Hebei,066699,China)

机构地区：[1]秦皇岛市第二医院心内科,河北秦皇岛066699

出　　处：《心血管康复医学杂志》2025年第2期140-145,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：2023年秦皇岛市科学技术研究与发展计划自筹项目(202301A282)。

摘　　要：目的:探讨慢性心力衰竭(CHF)患者一氧化氮(NO)、内皮素-1(ET-1)、血栓素B2(TXB2)变化及其与血浆脑钠肽(BNP)水平的相关性。方法:纳入秦皇岛市第二医院2022年1月至2022年12月收治的110例CHF患者为研究对象,根据纽约心脏病协会(NYHA)心功能分级将患者分为心功能Ⅱ级组(n=22)、心功能Ⅲ级组(n=50)和心功能Ⅳ级组(n=38);比较三组患者基线资料、NO、ET-1、TXB2、BNP水平及其他相关实验室指标。采用Pearson相关分析CHF患者NO、ET-1、TXB2与血浆BNP的相关性。多元线性回归分析CHF患者BNP水平升高的相关因素。结果:与心功能Ⅱ级组、心功能Ⅲ级组比较,心功能Ⅳ级组尿酸[(467.39±32.60)μmol/L比(367.25±22.39)μmol/L比(421.42±28.34)μmol/L]、总胆红素[(17.36±3.10)μmol/L比(10.65±1.39)μmol/L比(11.12±2.01)μmol/L]、BNP[(897.60±50.11)ng/L比(381.37±31.25)ng/L比(527.60±47.84)ng/L]、NO[(50.12±5.95)μmol/L比(25.36±2.14)μmol/L比(37.92±4.84)μmol/L]、ET-1[(114.10±10.53)pg/L比(80.25±7.38)pg/L比(97.03±8.40)pg/L]、TXB2[(417.98±29.35)pg/ml比(302.63±19.63)pg/ml比(381.29±26.44)pg/ml]水平显著升高(P均<0.001),且与心功能Ⅱ级组比较,心功能Ⅲ级组上述指标水平(总胆红素除外)均显著升高(P均<0.001)。经Pearson相关性分析结果显示,血浆NO、ET-1、TXB2与BNP呈显著正相关(r=0.828、0.750、0.720,P均<0.001)。多元线性回归分析结果显示,尿酸、总胆红素、血浆NO、ET-1、TXB2水平是CHF患者BNP水平升高的独立危险因素(B=0.555~20.550,P<0.05或<0.01),使用血管紧张素转化酶抑制剂(ACEI)/血管紧张素Ⅱ受体阻滞剂(ARB)是其独立保护因素(B=-46.222,P=0.027)。结论:NO、ET-1、TXB2水平与CHF的发生、发展密切相关,且随着CHF的进展,三者呈升高趋势,且与BNP关系密切。Objective:To investigate the changes of nitric oxide(NO),endothelin-1(ET-1),thromboxane B2(TXB2)levels in patients with chronic heart failure(CHF)and their correlation with plasma brain natriuretic peptide(BNP).Methods:We enrolled 110 CHF patients admitted in the Second Hospital of Qinhuangdao between January and December 2022.According to the New York Heart Association(NYHA)cardiac function classification,the patients were divided into cardiac function class II group(n=22),cardiac function class III group(n=50),and cardiac function class IV group(n=38).Baseline data,levels of NO,ET-1,TXB2,BNP and other related laboratory indexes were compared among three groups.Pearson correlation analysis was used to analyze the association of NO,ET-1,TXB2 with plasma BNP in CHF patients.Multivariate linear regression was employed to analyze related factors of elevated BNP in CHF patients.Results:Compared with patients in class II group and class III group,those in class IV group had significant higher uric acid[(467.39±32.60)μmol/L vs.(367.25±22.39)μmol/L vs.(421.42±28.34)μmol/L],total bilirubin[(17.36±3.10)μmol/L vs.(10.65±1.39)μmol/L vs.(11.12±2.01)μmol/L],BNP[(897.60±50.11)ng/L vs.(381.37±31.25)ng/L vs.(527.60±47.84)ng/L],NO[(50.12±5.95)μmol/L vs.(25.36±2.14)μmol/L vs.(37.92±4.84)μmol/L],ET-1[(114.10±10.53)pg/L vs.(80.25±7.38)pg/L vs.(97.03±8.40)pg/L],TXB2[(417.98±29.35)pg/ml vs.(302.63±19.63)pg/ml vs.(381.29±26.44)pg/ml](P<0.001 all).Compared with those in class II group,those in class III group had significant higher above-mentioned indexes(except total bilirubin)(P<0.001 all).Pearson correlation analysis indicated that plasma NO,ET-1,TXB2 were positively associated with BNP(r=0.828,0.750,0.720,P<0.001 all).Multivariate linear regression analysis indicated that uric acid,total bilirubin,plasma NO,ET-1 and TXB2 levels were independent risk factors for elevated BNP level in CHF patients(B=0.555~20.550,P<0.05 or<0.01),while the use of angiotensin converting enzyme inhibitors(ACEI)/angiotensin II re

关 键 词：心力衰竭 一氧化氮 内皮缩血管肽1 利钠肽 脑 

分 类 号：R541.61[医药卫生—心血管疾病]