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目的探讨血钠水平对收缩性心力衰竭患者肾素-血管紧张素-醛固酮系统(RAAS)、血浆脑钠肽水平的影响。方法选取陕西中医药大学附属医院2013年5月—2016年5月收治的收缩性心力衰竭患者300例,按照血钠水平分为低钠组(血钠水平<135 mmol/L,n=150)和正常组(血钠水平≥135 mmol/L,n=150)。比较两组患者血浆肾素、血管紧张素、醛固酮、脑钠肽水平,比较不同心功能分级患者血浆肾素、血管紧张素、醛固酮、脑钠肽及血钠水平,并分析血钠水平与血浆肾素、血管紧张素、醛固酮、脑钠肽水平的相关性。结果低钠组患者血浆肾素、血管紧张素、醛固酮、脑钠肽水平高于正常组(P<0.05)。心功能分级Ⅳ患者血浆肾素、血管紧张素、醛固酮、脑钠肽水平高于心功能分级Ⅱ级、Ⅲ级患者,血钠水平低于心功能分级Ⅱ级、Ⅲ级患者(P<0.05);心功能分级Ⅲ级患者血浆肾素、血管紧张素、醛固酮、脑钠肽水平高于心功能分级Ⅱ级患者,血钠水平低于心功能分级Ⅱ级患者(P<0.05)。直线相关性分析结果显示,血钠水平与收缩性心力衰竭患者血浆肾素(r=-0.425)、血管紧张素(r=-0.378)、醛固酮(r=-0.466)、脑钠肽(r=-0.621)水平呈负相关(P<0.05)。结论血钠水平降低会导致收缩性心力衰竭患者RAAS激活、血浆脑钠肽水平升高,进而加重患者心功能损伤。
Objective To investigate the effect of serum sodium level on renin-angiotensin-aldosterone system (RAAS) and plasma brain natriuretic peptide in patients with systolic heart failure. Methods 300 cases of systolic heart failure admitted to Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from May 2013 to May 2016 were divided into the low sodium group (serum sodium level <135 mmol / L, n = 150) And normal group (serum sodium level ≥135 mmol / L, n = 150). The levels of plasma renin, angiotensin, aldosterone and brain natriuretic peptide were compared between the two groups. Plasma renin, angiotensin, aldosterone, brain natriuretic peptide and serum sodium levels were compared among patients with different cardiac function scores. Plasma sodium levels Renin, angiotensin, aldosterone, brain natriuretic peptide levels. Results The levels of plasma renin, angiotensin, aldosterone and brain natriuretic peptide in patients with low sodium group were significantly higher than those in normal group (P <0.05). The levels of plasma renin, angiotensin, aldosterone and brain natriuretic peptide in patients with grade IV heart function were higher than those in grade Ⅱand Ⅲ patients with cardiac function grade Ⅳ, and the level of serum sodium was lower than those in grade Ⅱ and Ⅲ patients with cardiac function grade Ⅳ (P <0.05) The levels of plasma renin, angiotensin, aldosterone and brain natriuretic peptide in patients with grade Ⅲ cardiac function were higher than those in patients with grade Ⅱ cardiac function, and the level of serum sodium was lower than that in patients with grade Ⅱ cardiac function (P <0.05). The linear correlation analysis showed that serum sodium levels were positively correlated with plasma renin (r = -0.425), angiotensin (r = -0.378), aldosterone (r = -0.466) and brain natriuretic peptide (r = -0.621) (P <0.05). Conclusions The decrease of serum sodium level leads to the activation of RAAS and the increase of plasma brain natriuretic peptide in patients with systolic heart failure, which further aggravates the cardiac dysfunction.