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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急性发作期和缓解期的水平及其临床意义。方法以放射免疫法检测观察组100例慢性肺源性心脏病急性加重期和缓解期及正常对照组60例健康体检者血浆CNP、ADM水平的变化,同时测定血氧分压和二氧化碳分压。结果 (1)观察组患者急性加重期和临床缓解期血浆CNP[(60.21±15.48)ng/L,(48.95±29.40)ng/L],ADM[(45.66±28.64)pg/ml,(28.95±14.35)pg/ml]水平均显著高于正常对照组[(20.16±5.56)ng/L,(19.98±5.43)pg/ml],差异有统计学意义(P<0.01);(2)观察组急性加重期血浆CNP、ADM水平显著高于临床缓解期(P<0.01);(3)观察组患者CNP、ADM与血氧分压呈负相关(r=-0.622,-0.702,P<0.05),与血二氧化碳分压无明显相关性(r=0.205,0.233,P>0.05);(4)血浆CNP与ADM呈正相关(r=0.279,P<0.05)。结论血浆CNP、ADM水平变化可以反映慢性肺源性心脏病患者的临床病情变化。
Objective To investigate the clinical significance and clinical significance of C-type natriuretic peptide (CNP) and adrenomedullin (ADM) in patients with acute episode and remission of chronic cor pulmonale. Methods Radioimmunoassay was used to detect the changes of plasma CNP and ADM in 100 cases of chronic cor pulmonale with acute exacerbation and remission in 60 healthy controls and normal control group. The partial pressure of oxygen and partial pressure of carbon dioxide were measured simultaneously. Results (1) The levels of CNP in the patients with acute exacerbation and clinical remission (60.21 ± 15.48ng / L, (48.95 ± 29.40) ng / L], ADM [(45.66 ± 28.64) pg / 14.35) pg / ml] were significantly higher than those in the normal control group [(20.16 ± 5.56) ng / L, (19.98 ± 5.43) pg / ml] (3) The CNP and ADM in the observation group were negatively correlated with the partial pressure of blood oxygen (r = -0.622, -0.702, P <0.05); the levels of plasma CNP and ADM in the acute exacerbation phase were significantly higher than those in the clinical remission (R = 0.205,0.233, P> 0.05). (4) There was a positive correlation between plasma CNP and ADM (r = 0.279, P <0.05). Conclusion The changes of plasma CNP and ADM levels may reflect the clinical changes in patients with chronic cor pulmonale.