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目的 观察不同程度的充血性心力衰竭 (CHF)患者药物治疗前后肾上腺髓质素前体N端 2 0肽(PAMP)血浆含量变化 ,以探讨其临床意义。方法 用特异性放射免疫法检测了 45例CHF患者和 7例健康对照者PAMP血浆含量。结果 随心功能恶化 ,PAMP明显降低 ,在心功能Ⅳ级组PAMP水平 [( 2 79± 0 89)pg·mL- 1 ]明显低于Ⅱ级组 [( 6 2 4± 1 71)pg·mL- 1 ]、Ⅲ级组 [( 7 3 8± 1 2 8)pg·mL- 1 ]和对照组 [( 8 5 6± 2 44 )pg·mL- 1 ] ( P<0 0 5 ) ,而Ⅱ、Ⅲ级组间和对照组比较无明显差异 (P >0 0 5 )。经 7d药物有效治疗 ,心衰症状缓解后 ,血浆PAMP浓度在心功能各亚组间并未发生明显改变 ,心功能Ⅳ级组仍维持较低水平。结论 PAMP参与了CHF发生发展的病理过程 ,可作为重度心衰的一项评定指标 ,短期药物治疗不能逆转PAMP血浆水平
Objective To observe the plasma levels of N-terminal 20 peptide (PAMP) in patients with congestive heart failure (CHF) before and after drug treatment to explore its clinical significance. Methods The plasma levels of PAMP in 45 CHF patients and 7 healthy controls were detected by specific radioimmunoassay. Results The cardiac function deteriorated and PAMP decreased significantly. The level of PAMP in heart function Ⅳ group [(2 79 ± 0 89) pg · mL-1] was significantly lower than that in group Ⅱ [(62.4 ± 1 71) pg · mL -1 (P <0.05), grade Ⅲ [(73.8 ± 122.8) pg · mL-1], and control group [(866 ± 2 44) pg · mL- No significant difference was found between grade Ⅲ group and control group (P> 0.05). After 7 days of effective drug treatment, heart failure symptoms relieved, plasma PAMP concentration did not change significantly between the various subgroups of cardiac function, cardiac function Ⅳ level group remained at a low level. Conclusions PAMP is involved in the pathological process of CHF development and can be used as an assessment index for severe heart failure. Short-term drug treatment can not reverse PAMP plasma levels