慢性心力衰竭患者血清和肽素水平与心功能的关系
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摘要
目的 :探讨血清和肽素(copeptin)与氨基末端脑钠肽前体(NT-pro BNP)、左心室射血分数(LVEF)、慢性心力衰竭(CHF)严重程度之间的相关性。方法:筛选78例CHF患者,收集其临床相关数据,按纽约心脏病学会(NYHA)心功能分级分为心功能Ⅱ级组22例、心功能Ⅲ级组33例、心功能Ⅳ级组23例,另选取同时期住院的心脏超声及冠状动脉造影正常、无器质性心脏病患者44例为对照组。用酶联免疫吸附法测定研究对象的血清和肽素和NT-pro BNP水平,同时行心脏超声检测其LVEF、左心室舒张末期内径(LVEDD),比较不同心功能分级组及对照组之间各项指标的差别和相关性。结果:CHF组血清和肽素水平明显高于对照组[(543.1±50.8)ng/L比(365.2±53.3)ng/L,P<0.01]。血清和肽素和NT-pro BNP水平在NYHA心功能分级Ⅱ、Ⅲ、Ⅳ级组中依次升高。和肽素水平与LVEF呈明显负相关(r=-0.646,P<0.01),与NT-pro BNP水平(r=0.595,P=0.016)和LVEDD水平(r=0.695,P<0.01)呈明显正相关。结论 :血清和肽素水平与NT-pro BNP、LVEF等临床常用的心功能评价指标存在相关性,对CHF患者的心功能评价具有一定临床意义。
Objective To investigate the correlation between serum copeptin, N-terminal pro-brain natriuretic peptide(NT-pro BNP), left ventricular ejection fraction(LVEF) and severity of chronic heart failure(CHF). Methods A total 78 CHF patients were enrolled and categorized into 3 groups according to New York Heart Association(NYHA} classification:classⅡ(22 cases), class Ⅲ(33 cases) and class Ⅳ(23 cases). Forty-four patients with normal cardiac function assessed by echocardiography were selected as controls. Serum copeptin and NT-pro BNP were assessed by enzyme linked imunosorbent assay(ELISA). All patients received echocardiography to measure LVEF and left ventricular end diastolic dimension(LVEDD). Results Serum copeptin level was significantly higher in CHF patients than in control group [(543.1±50.8) ng/L vs(365.2 ±53.3) ng/L, P <0.01)]. Levels of serum copeptin and NT-pro BNP were increased with the increase in NYHA grading. Serum copeptin was negatively correlated with LVEF(r =-0.646, P <0.01), and positively correlated with serum NT-pro BNP(r=0.595, P=0.016)and LVEDD(r=0.695, P<0.01). Conclusions Serum copeptin level has a significant correlation with NT-pro BNP and LVEF. Therefore, it is helpful for evaluating cardiac function in CHF patients.
Objective To investigate the correlation between serum copeptin, N-terminal pro-brain natriuretic peptide(NT-pro BNP), left ventricular ejection fraction(LVEF) and severity of chronic heart failure(CHF). Methods A total 78 CHF patients were enrolled and categorized into 3 groups according to New York Heart Association(NYHA} classification:classⅡ(22 cases), class Ⅲ(33 cases) and class Ⅳ(23 cases). Forty-four patients with normal cardiac function assessed by echocardiography were selected as controls. Serum copeptin and NT-pro BNP were assessed by enzyme linked imunosorbent assay(ELISA). All patients received echocardiography to measure LVEF and left ventricular end diastolic dimension(LVEDD). Results Serum copeptin level was significantly higher in CHF patients than in control group [(543.1±50.8) ng/L vs(365.2 ±53.3) ng/L, P <0.01)]. Levels of serum copeptin and NT-pro BNP were increased with the increase in NYHA grading. Serum copeptin was negatively correlated with LVEF(r =-0.646, P <0.01), and positively correlated with serum NT-pro BNP(r=0.595, P=0.016)and LVEDD(r=0.695, P<0.01). Conclusions Serum copeptin level has a significant correlation with NT-pro BNP and LVEF. Therefore, it is helpful for evaluating cardiac function in CHF patients.
引文
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[6]吴穷,李慧,任妍,等.体质量指数对慢性心力衰竭患者预后的影响[J].内科理论与实践,2016,11(3):176-179.
[7]李晓涛,夏岳,郭喜朝,等.血浆和肽素、B型利钠肽水平与慢性心力衰竭的关系[J].临床心血管病杂志,2011,27(4):268-270.
[8]Voors AA,von Haehling S,Anker SD,et al.C-terminal provasopressin(copeptin)is a strong prognostic marker in patients with heart failure after an acute myocardial infarction:results from the OPTIMAAL study[J].Eur Heart J,2009,30(10):1187-1194.
[9]Stoiser B,Mortl D,Hülsmann M,et al.Copeptin,a fragment of the vasopressin precursor,as a novel predictor of outcome in heart failure[J].Eur J Clin Invest,2006,36(11):771-778.
[10]赵玉清,袁桂莉,张进顺,等.和肽素联合N末端B型利钠肽原评估慢性心力衰竭患者预后的价值[J].中国循环杂志,2014,29(4):275-278.
[11]Wasilewski MA,Myers VD,Recchia FA,et al.Arginine vasopressin receptor signaling and functional outcomes in heart failure[J].Cell Signal,2016,28(3):224-233.
[12]Fan YH,Zhao LY,Zheng QS,et al.Arginine vasopressin increases i NOS-NO system activity in cardiac fibroblasts through NF-kappa B activation and its relation with myocardial fibrosis[J].Life Sci,2007,81(4):327-335.
[2]Balling L,Gustafsson F.Copeptin as a biomarker in heart failure[J].Biomark Med,2014,8(6):841-854.
[3]Jochberger S,Morgenthaler NG,Mayr VD,et al.Copeptin and arginine vasopressin concentrations in critically ill patients[J].J Clin Endocrinol Metab,2006,91(11):4381-4386.
[4]Nakamura T,Funayama H,Yoshimura A,et al.Possible vascular role of increased plasma arginine vasopressin in congestive heart failure[J].Int J Cardiol,2006,106(2):191-195.
[5]Tentzeris I,Jarai R,Farhan S,et al.Complementary role of copeptin and high-sensitivity troponin in predicting outcome in patients with stable chronic heart failure[J].Eur J Heart Fail,2011,13(7):726-733.
[6]吴穷,李慧,任妍,等.体质量指数对慢性心力衰竭患者预后的影响[J].内科理论与实践,2016,11(3):176-179.
[7]李晓涛,夏岳,郭喜朝,等.血浆和肽素、B型利钠肽水平与慢性心力衰竭的关系[J].临床心血管病杂志,2011,27(4):268-270.
[8]Voors AA,von Haehling S,Anker SD,et al.C-terminal provasopressin(copeptin)is a strong prognostic marker in patients with heart failure after an acute myocardial infarction:results from the OPTIMAAL study[J].Eur Heart J,2009,30(10):1187-1194.
[9]Stoiser B,Mortl D,Hülsmann M,et al.Copeptin,a fragment of the vasopressin precursor,as a novel predictor of outcome in heart failure[J].Eur J Clin Invest,2006,36(11):771-778.
[10]赵玉清,袁桂莉,张进顺,等.和肽素联合N末端B型利钠肽原评估慢性心力衰竭患者预后的价值[J].中国循环杂志,2014,29(4):275-278.
[11]Wasilewski MA,Myers VD,Recchia FA,et al.Arginine vasopressin receptor signaling and functional outcomes in heart failure[J].Cell Signal,2016,28(3):224-233.
[12]Fan YH,Zhao LY,Zheng QS,et al.Arginine vasopressin increases i NOS-NO system activity in cardiac fibroblasts through NF-kappa B activation and its relation with myocardial fibrosis[J].Life Sci,2007,81(4):327-335.