CAJ | 학술논문

目的：探讨慢性心力衰竭(CHF)患者心功能分级或不同病因对神经内分泌水平及心功能状态的影响。方法将我院CHF患者168例根据心功能分级分为A组72例(Ⅲ级)、B组96例(Ⅳ级)，并根据基础病因分为Ⅰ组76例(冠心病)、Ⅱ组52例(扩张性心肌病)、Ⅲ组40例(高血压病)，对不同病因及心功能分级的肾素(PRA)、血管紧张素(AngⅡ)、醛固酮(ALD)、脑钠肽(BNP)水平及左室舒张末内径(LVEDD)、左室射血分数(LVEF)进行比较分析。结果 B组PRA、AngⅡ、ALD、BNP、LVEDD及LVEF检测值显著高于B组，差异有统计学意义(P <0.05)。Ⅰ、Ⅱ、Ⅲ三组上述检测值无统计学差异(P >0.05)。结论CHF患者心功能越差，其神经内分泌水平被激活得更明显，从而促进了PRA、AngⅡ、ALD及BNP的释放，并加剧了心室重构现象。
목적：탐토만성심력쇠갈(CHF)환자심공능분급혹불동병인대신경내분비수평급심공능상태적영향。방법장아원CHF환자168례근거심공능분급분위A조72례(Ⅲ급)、B조96례(Ⅳ급)，병근거기출병인분위Ⅰ조76례(관심병)、Ⅱ조52례(확장성심기병)、Ⅲ조40례(고혈압병)，대불동병인급심공능분급적신소(PRA)、혈관긴장소(AngⅡ)、철고동(ALD)、뇌납태(BNP)수평급좌실서장말내경(LVEDD)、좌실사혈분수(LVEF)진행비교분석。결과 B조PRA、AngⅡ、ALD、BNP、LVEDD급LVEF검측치현저고우B조，차이유통계학의의(P <0.05)。Ⅰ、Ⅱ、Ⅲ삼조상술검측치무통계학차이(P >0.05)。결론CHF환자심공능월차，기신경내분비수평피격활득경명현，종이촉진료PRA、AngⅡ、ALD급BNP적석방，병가극료심실중구현상。
Objective To explore the effect of cardiac function classification or different etiology on neuroendocrine levels and heart function in patients with chronic heart failure. Methods 168 patients with chronic heart failure of tour hospital were divided into group A(72 cases, grade Ⅲ) and B(96 cases, grade Ⅳ) according to cardiac function classification, and were divided into groupⅠ(coronary), Ⅱ(dilated cardiomyopathy) and Ⅲ (hypertension) according to basic etiology. PRA, AngⅡ, ALD, BNP, LVEDD, LVEF of different etiology and cardiac function classification were compared and analyzed. Results Level of PRA, AngⅡ, ALD, BNP, LVEDD and LVEF of group B were higher than group A significantly(P <0.05). Level of PRA, AngⅡ, ALD, BNP, LVEDD and LVEF among group Ⅰ, Ⅱand Ⅲ were not significant(P >0.05). Conclusion The worse of cardiac function, the more obviously of neuroendocrine levels were activated, the phenomenon promotes the release of PRA, AngⅡ, ALD and BNP, adding to ventricular remodeling.