| Objective:To explore the variance of plasma concentration of Antidiuretic hormone and B-type natriuretic peptide by detecting the indices of ADH and BNP with heart failure.To analyze the difference of above-mentioned indeces between serum sodium level groups and correlation between serum sodium and above indeces.Methods:61 patients with definited congestive heart failure selected from 2008.7 to 2009.9 in department of cardiology of our hospital were divided into two groups according to serum sodium levels and NYHA classification seperately.The NYHA classification group were divided into two groups:NYHAⅢgroup of 23 patients with NYHAⅣgroup of 38 patients,;The serum sodium groups were divided into two sub-groups according to NYHA classification,in which hyponatremia group of 29 patients with normal serum sodium group of 32 patients.There are NYHAⅢsub-group of 11 patients with NYHAⅣsub-group of 18 patients in hyponatremia group,and NYHAⅢsub-group of 12 patients with NYHAIV sub-group of 20 patients in normal serum sodium group. Generral conditions of all selected patients were collected. The ADH and BNP level of all selected were measured and compared according to above-mentioned groups.At last, correlation analysis was applied to show the correlation of serum sodium level with above indeces.Results:①Serum ADH and BNP concentration were increased as the NYHA class of heart failure increased,ADH(59.3±18.51vs62.5±18.69 P<0.01),BNP (319.3±114.73vs473.5±116.92 P<0.001)②After excluding the effection of serum sodium level,serum ADH and BNP concentration were increased as the NYHA class of heart failure increased.Normal serum sodium group:ADH(53.6±18.16vs54.9±17.67 P<0.05),BNP(258.5±62.19vs405.3±102.92 P<0.001); Hyponatremia group:ADH (65.3±19.23vs69.5±20.16 P<0.01),BNP (380.1±113.63vs564.0±125.27 P<0.001)③After excluding the influence of heart function,Serum ADH and BNP level in patients with hyponatremia was significantly higher than that in patients with normal serum sodium concentration,NYHAⅢsub-group:ADH (65.3±19.23vs53.6±18.16 P<0.01),BNP (380.1±113.63vs258.5±62.19 P<0.001), NYHAⅣsub-group:ADH(69.5±20.16vs54.9±17.67 P<0.01),BNP (564.0±125.27vs405.3±102.92 P<0.001);④Serum sodium level was negative correlated with ADH and BNP(r=-0.354,P<0.01;r=-0.396 P<0.01).Conclusion1.With the NYHA class of heart failure increased, serum ADH and BNP concentration in patients with heart failure increased,regardless of the serum sodium level. It suggested that ADH and BNP were participated in the development of the heart failure, and could be used to evaluate the state of disease.2.Serum ADH and BNP level in patients with hyponatremia was significantly higher than that in patients with normal serum sodium concentration. In the sample regression,serum sodium level was negative correlated with ADH and BNP. It showed that heart failure with hyponatremia were related with elevation of ADH and BNP,neurohumour activation in patients with congestive heart failure with hyponatremia is higher than that of normal serum sodium. |
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