慢性心力衰竭伴低钠血症患者血浆血管加压素和脑钠肽水平的变化  

Plasma Arginine Vasopressin and Brain Natriuretic Peptide Level in Chronic Heart Failure Patients With Hyponatremia

作　　者：贺桦[1] 许顶立[1] 刘彦波[1] 

机构地区：[1]中国人民解放军第一军医大学南方医院心血管内科,广东省广州市510515

出　　处：《中国循环杂志》2004年第2期88-90,共3页Chinese Circulation Journal

摘　　要：的 :探讨血管加压素 (AVP)、脑钠肽 (BNP)在慢性心力衰竭伴低钠血症发生发展过程中的作用。方法 :用放射免疫法同时测定 77例慢性心力衰竭患者 (心力衰竭组 ) ,包括 3 4例伴低钠血症慢性心力衰竭患者和 43例正常血钠的慢性心力衰竭患者以及 3 6例健康志愿者 (正常对照组 )血浆AVP、BNP水平。结果 :两组心力衰竭患者血浆AVP、BNP水平均较正常对照组升高 ,伴低钠血症心力衰竭患者升高更为显著。随心功能级别增高 ,血浆AVP、BNP水平升高更明显。血浆AVP与BNP水平呈显著正相关 (r =0 5 15 ,P <0 0 0 1) ,而血浆AVP、BNP水平越高 ,血钠越低 ,呈显著负相关 (分别为r =-0 40 3 ,P <0 0 0 1;r =-0 3 94,P <0 0 0 1)。结论 :心力衰竭患者血浆AVP、BNP分泌明显异常 ,AVP、BNP分泌增加可能是导致心力衰竭低钠血症的重要原因之一 ,在低钠血症发生中两者可能为协同作用。Objective: To explore the effects of arginine vasopressin(AVP) and brain natriuretic peptide(BNP) in the development of hyponatremia in chronic heart failure (CHF) and to assess their relationship. Methods: Plasma levels of AVP and BNP were measured with radioimmunology assay in 34 CHF patients with hyponatremia,43 CHF patients without hyponatremia and 36 health volunteers.At the same time,serum sodium was determined. Results: ①Plasma levels of AVP and BNP in CHF patients were higher than those in heath group.In CHF patients,the levels of plasma AVP and BNP were much higher in the group with hyponatremia than those with normal blood sodium.②The levels of plasma AVP and BNP increased significantly with incremental NYHA classes.③The plasma AVP level was positive correlate with plasma BNP level ( r =0.515, p <0.001).Moreover,there was a significant negative correlation between the plasma levels of AVP,BNP and serum sodium concentration ( r =-0.403, p <0.001; r =-0.394, p <0.001). Conclusions: The secretion of plasma AVP and BNP was significantly abnormal in CHF patients.The enhanced secretion of AVP and BNP may play important roles in hyponatremia of CHF patients.

关 键 词：慢性心力衰竭 低钠血症 血浆 血管 加压素 脑钠肽 

分 类 号：R541.6[医药卫生—心血管疾病]