血浆和肽素、N末端脑钠肽前体和肾上腺髓质素前体N端20肽与慢性心力衰竭的关系研究

Relationship between plasma copeptin, proadrenomedullin N-terminal 20 peptide，N-terminal pro-brain natriuretic peptide levels and chronic heart failure

摘要:

目的：探讨血浆和肽素、肾上腺髓质素前体N端20肽（proadrenomedullin N-terminal 20 peptide，PAMP）、N末端脑钠肽前体（N-terminal pro-brain natriuretic peptide，NT-proBNP）水平和慢性心力衰竭（chronic heart failure，CHF）及其严重程度的相关关系。方法：分别入选CHF患者72例和32例非CHF对照，检测纳入对象血浆和肽素、PAMP和NT-proBNP水平，心脏彩超评价心脏的结构和功能。结果：CHF患者血浆和肽素、NT-proBNP水平与对照组相比明显升高（P<0.001），并随纽约心脏病协会（New York heart association，NYHA）分级的增加而升高。和肽素分别与左室舒张末期内径值（r=0.508）、血肌酐（r=0.320）、NYHA分级（r=0.567）、NT-proBNP（r=0.412）呈显著正相关（均有P<0.01），与左室射血分数呈负相关（r=-0.663，P<0.01）。CHF患者血浆PAMP水平与对照组相比无显著差异。结论：血浆和肽素、NT-proBNP水平在CHF中显著升高，并与CHF的严重程度密切相关。

Abstract:

Objective：To investigate the relationship between plasma copeptin，proadrenomedullin N-terminal 20 peptide （PAMP），N-terminal pro-brain natriuretic peptide（NT-proBNP） levels and severity of chronic heart failure（CHF）. Methods：Seventy-two patients with CHF and 32 non-CHF controls were enrolled. Plasma copeptin and PAMP concentrations were measured by ELISA and concen－tration of NT-proBNP was detected by triaged detection instrument. Cardiac structure and function were evaluated by color Doppler ultrasound. Results：Plasma copeptin and NT-proBNP levels were significantly higher in patients with CHF than in non-CHF controls（P<0.001），which were elevated with the increase of the New York heart association（NYHA） class. Concentration of copeptin was posi－tively correlated with left ventricular end-diastolic diameter（LVEDD） （r=0.508），serum creatinine（r=0.320），NYHA class（r=0.567），NT-proBNP（r=0.412） （all P<0.01） and was negatively correlated with left ventricular ejection fraction（r=-0.663，P<0.01）. There was no significant difference in terms of plasma PAMP levels between patients with CHF and non-CHF controls. Conclusions：Plasma copeptin and NT-proBNP levels are higher in patients with CHF and are closely related with the severity of CHF.