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目的探索慢性收缩性心力衰竭(CHF)患者血钠水平与血浆肾素-血管紧张素-醛固酮系统(RAAS)及脑钠肽(BNP)水平的关系。方法 125例于本院接受治疗的CHF患者被纳入研究,且按照其血钠水平分为低血钠组和正常血钠组,检测其血浆肾素(PRA)、血管紧张素(AngⅡ)、醛固酮(ALD)及脑钠肽(BNP)水平,并作相关性分析。结果低血钠组患者PRA、AngⅡ及ALD、BNP水平明显高于正常血钠组患者,差异均有统计学意义(P<0.05);与NYHAⅡ级患者比较,NYHAⅢ级和NYHAⅣ级患者血钠水平均有明显降低,PRA、AngⅡ及ALD、BNP水平均有明显增加,差异均有统计学意义(P<0.05);而与NYHAⅢ级患者比较,NYHAⅣ级患者血钠水平均有明显降低,PRA、AngⅡ及ALD、BNP水平均有明显增加,差异均有统计学意义(P<0.05);血钠水平与患者PRA、AngⅡ及ALD、BNP水平均呈显著负相关(r值分别为-0.422、-0.367、-0.499、-0.622,P<0.05)。结论慢性收缩性心力衰竭患者低血钠水平可能会促进RAAS及神经内分泌激素激活。
Objective To explore the relationship between serum sodium level and plasma renin-angiotensin-aldosterone system (RAAS) and brain natriuretic peptide (BNP) levels in patients with chronic systolic heart failure (CHF). Methods A total of 125 CHF patients treated in our hospital were enrolled in the study. According to the level of serum sodium, they were divided into hyponatremia group and normal sodium group. The levels of plasma renin (PRA), angiotensin (Ang Ⅱ), aldosterone (ALD) and brain natriuretic peptide (BNP) levels, and make correlation analysis. Results The levels of PRA, AngⅡ, ALD and BNP in patients with hyponatremia were significantly higher than those in patients with normal sodium (P <0.05). Compared with NYHA Ⅱ patients, the levels of serum sodium (P <0.05). Compared with NYHAⅢ patients, the levels of serum sodium in patients with NYHAⅣwere significantly decreased, and the levels of PRA, AngⅡ, ALD and BNP were significantly increased (P <0.05). There was a significant negative correlation between serum sodium level and the levels of PRA, AngⅡ, ALD and BNP (r = -0.422, - 0.367, -0.499, -0.622, P <0.05). Conclusion Hypokalemia in patients with chronic systolic heart failure may promote the activation of RAAS and neuroendocrine hormones.