[慢性心力衰竭患者低钠血症与血浆肾素活性、抗利尿激素及脑钠肽的相关性]

[Correlation of hyponatremia with plasma renin activity, antidiuretic hormone and brain natriuretic peptide in chronic heart failure].

作者信息

Fu Lu, Ge Hai-long, Li Jia, Chen Guang-yuan, Li Yuan-shi, Xie Rong-sheng, Fan Chun-yan

机构信息

Department of Cardiology, First Clinical College of Harbin Medical University, Harbin 150001, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2006 Sep;34(9):781-3.

PMID:17217682

Abstract

OBJECTIVE

To observe the changes of plasma renin activity, antidiuretic hormone and brain natriuretic peptide in chronic heart failure (CHF) and their correlation with hyponatremia.

METHODS

Plasma levels of PRA, ADH, and BNP were measured by radioimmunology in 76 CHF patients. Forty-one out of 76 CHF patients with hyponatremia and 35 CHF patients without hyponatremia were identified by serum sodium. The rates of rehospitalization within 3 months were compared in two groups.

RESULTS

Levels of plasma renin activity, ALD, and BNP in CHF patients with hyponatremia were notably higher than those in patients without hyponatremia classified by New York Heart Association (NYHA) grade II - IV: PRA [(2.7 +/- 1.0) ng.ml(-1).h(-1) vs. (1.8 +/- 0.7) ng.ml(-1).h(-1), (4.3 +/- 1.2) ng.ml(-1).h(-1) vs. (3.0 +/- 0.9) ng.ml(-1).h(-1), (5.6 +/- 1.3) ng.ml(-1).h(-1) vs. (3.5 +/- 1.1) ng.ml(-1).h(-1), respectively, P < 0.05], ADH [(59.7 +/- 17.4) ng/L vs. (48.6 +/- 15.3) ng/L, (68.4 +/- 17.6) ng/L vs. (56.3 +/- 19.2) ng/L, (75.3 +/- 20.0) ng/L vs. (51.4 +/- 16.2) ng/L, respectively, P < 0.05] and BNP [(276.4 +/- 75.2) ng/L vs. (185.3 +/- 55.3) ng/L, (380.1 +/- 113.6) ng/L vs. (258.5 +/- 62.1) ng/L, (564.0 +/- 125.2) ng/L vs. (405.3 +/- 102.9) ng/L, respectively, P < 0.05]. In the simple regression analyses, hyponatremia was negative correlated with PRA, ADH and BNP (r = -0.31, P < 0.05; r = -0.28, P < 0.05, r = -0.80, P < 0.01). The rate of rehospitalization within 3 months in hyponatremia group was higher than that in control group.

CONCLUSIONS

There is relation of hyponatremia to the changes of plasma renin activity, antidiuretic hormone and brain natriuretic peptide in chronic heart failure. Hyponatremia may accelerate the excretion of plasma PRA, ADH and BNP in chronic heart failure. Neuroendocrine activation in patients of congestive heart failure with hyponatremia is higher than that of normal natremia group.

摘要

目的

观察慢性心力衰竭（CHF）患者血浆肾素活性、抗利尿激素及脑钠肽的变化及其与低钠血症的相关性。

方法

采用放射免疫法测定76例CHF患者血浆中PRA、ADH及BNP水平。根据血清钠水平，76例CHF患者中41例为低钠血症患者，35例为非低钠血症患者。比较两组患者3个月内的再住院率。

结果

低钠血症的CHF患者血浆肾素活性、醛固酮及BNP水平显著高于非低钠血症患者，按纽约心脏协会（NYHA）分级Ⅱ - Ⅳ级比较：PRA[分别为(2.7±1.0)ng·ml⁻¹·h⁻¹对(1.8±0.7)ng·ml⁻¹·h⁻¹、(4.3±1.2)ng·ml⁻¹·h⁻¹对(3.0±0.9)ng·ml⁻¹·h⁻¹、(5.6±1.3)ng·ml⁻¹·h⁻¹对(3.5±1.1)ng·ml⁻¹·h⁻¹，P<0.05]，ADH[分别为(59.7±17.4)ng/L对(48.6±15.3)ng/L、(68.4±17.6)ng/L对(56.3±19.2)ng/L、(75.3±20.0)ng/L对(51.4±16.2)ng/L，P<0.05]及BNP[分别为(276.4±75.2)ng/L对(185.3±55.3)ng/L、(380.1±113.6)ng/L对(258.5±62.1)ng/L、(564.0±125.2)ng/L对(405.3±102.9)ng/L，P<0.05]。在简单回归分析中，低钠血症与PRA、ADH及BNP呈负相关（r = -0.31，P<0.05；r = -0.28, P<0.05；r = -0.80，P<0.01）。低钠血症组3个月内的再住院率高于对照组。