肺源性心脏病患者血浆C型利钠肽、肾上腺髓质素变化及意义.docVIP

肺源性心脏病患者血浆C型利钠肽、肾上腺髓质素变化及意义 　【摘要】 目的 探讨C型利钠肽(CNP)及肾上腺髓质素(ADM)在慢性肺源性心脏病中的作用和意义。方法 以住院的慢性肺源性心脏病患者作为实验组，以同期健康体检者作为对照组，用放射免疫法检测血浆中CNP、ADM的水平，比较CNP、ADM在实验组100例患者(慢性肺源性心脏病急性加重期和临床缓解期)和对照组60例健康体检者中水平的变化,同时测定血氧分压和二氧化碳分压。结果 (1)慢性肺源性心脏病急性加重期和临床缓解期的CNP、ADM含量均显著高于正常对照组(P＜0.01)；(2)慢性肺源性心脏病急性加重期CNP、ADM的含量显著高于临床缓解期(P＜0.01)；(3)慢性肺源性心脏病患者中CNP、ADM 与血氧分压呈负相关(r= -0.622,-0.702,P＜0.05)，与血二氧化碳分压相关性不明显(r=0.205,0.233,P＞0.05) ；(4)血浆CNP与ADM呈正相关 (r=0.279, P＜0.05)。结论 CNP、ADM参与了慢性肺源性心脏病的病理生理过程；通过观察血浆CNP、ADM水平变化,可以反映慢性肺源性心脏病的病情。　　【关键词】 C型利钠肽；肾上腺髓质素；肺源性心脏病 　　Changes of plasma c-type natriuretic peptide and plasma adrenomedullin in patients with chronic pulmonary heart disease 　　【Abstract】 Objective To explore the role and clinical significance of plasma c-type natriuretic peptide (CNP) and adrenomedullin (ADM) levels in patients with chronic pulmonary heart disease.Methods Patients with chronic pulmonary heart disease in hospital, including acute exacerbation stage or clinical alleviated stage totally 100 cases, were participated in the study as experiment group. Meanwhile, 60 cases healthy persons were served as control group. Plasma CNP and ADM were measured by radioimmoassay and compared in the two groups, oxygen partial pressure and carbon dioxide partial pressure were measured at the same time.Results (1) the levels of plasma CNP and ADM in urgent aggravation stage of experiment group and clinical alleviation stage all were higher than the control group (P＜0.01）；(2) the levels of plasma CNP and ADM in experiment group were higher than in control group significantly(r= -0.622, -0.702,P＜0.05)；(3) the levels of plasma CNP and ADM in patients with chronic pulmonary heart were negatively correlated with oxygen partial pressure but no relationship with carbon dioxide partial pressure(r=0.205,0.233,P＞0.05)；(4) The levels of plasma CNP was positively correlated with ADM(r=0.279, P＜0.05).Conclusion The plasma CNP and ADM were participated in the pathosphysiology process of pulmonary heart disease an