心虚证患者心钠素水平的初步观察及其临床意义探讨

作者	单位
俞兵	上海医科大学华山医院内科教研室
戴瑞鸿	上海医科大学华山医院内科教研室
王勇雄	上海医科大学华山医院内科教研室
王受益	上海医科大学中西医结合研究所心血管病研究室
王文健	上海医科大学中西医结合研究所心血管病研究室

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中文摘要:

用放射免疫法测定了24例心气虚(重证组和轻证组)、单纯心虚和非虚证四组患者的血浆心钠素样免疫活性物质(irANP),发现其含量在上述各组和西医心功能Ⅰ～Ⅳ级组中均呈递减现象,且在相应的中西医四组问无显著差别。irANP 与左室射血分数明显相关(r=-0.87)。故认为 irANP 可作为心气虚患者的客观指标之一,并能反映病证的严重度。同时再一次提示中医的虚证分型与心功能是相关的。

英文摘要:

Immunoreactive atrial natriuretic peptide(irANP)has been measured in 24 patients of various cardiac diseases by radioimmunoassay.According to the TCM,these patients were divided into 4 groups:cardiac energy deficiency mild(A)and severe(B)groups;shnple cardiac deficiency:(C);and the control(D).The New York Heart Association(NYHA)classification of cardiac function in 5 cases of group A were all degree Ⅳ;in 6 cases of group B were 2 of degree Ⅳ and 4 of degree Ⅲ; in 6 cases of group C were Ⅰ of degree Ⅲ,3 of degree Ⅱ and 2 of degree Ⅰ;and in 6 cases of group D were all degree Ⅰ.The results of chest X-ray and echocardiogram suggested that the classification of cardiac function was objective,The quantity of irANP in group A-D and NYH A Ⅳ～Ⅰ decreased gradually and was correlated with left ventricular ejection fraction(r=-0.87,P<0.01).The average amounts of irANP in the different TCM groups A-D were at the equavelent levels in the groups NYHA Ⅳ～Ⅰ.Meanwhile it was found that the cardiac energy deficiency patients had abnormality in some parameters of hemorrheology,but no correlation with ir ANP.it suggested that the diagnosis of cardiac deficiency by TCM was correlated with the different degree of NYHA in the sense of biochemical index of irANP.The irANP might be considered as one of the objective signs of the cardisc energy deficiency,which also might represent the severity of the disease.

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