【摘要】 将 112例充血性心力衰竭 (CHF)按照中医辨证分为单纯心病 (心气虚 )组 45例和心肾同病 (心肾阳虚 )组 67例 ,观察比较两组患者的心功能及心纳素 (ANP)、肾素 (Ren)、血管紧张素Ⅱ (AngⅡ )等检测指标 ,以探讨CHF患者“心肾同病”病机与循环激素的相关性。结果 :心肾同病组的心功能分级和心衰评分显著高于心病组 (P <0 .0 0 1) ;心病组ANP水平明显升高 ,心肾同病组ANP、RAS指标均明显升高 ,且后者与心病组比较有显著性差异 (P <0 .0 0 1)。提示ANP血浆浓度的上升是“心气虚证”的标志 ,RAS的激活标志着“心肾同病”病机 ,上述指标也可作为CHF病情判断及药物疗效评估的依据之一。更多还原

【Abstract】 Based upon pattern identification in Chinese medicine,112 cases of congestive heat(CHF) failure were divided into 45 cases in the simple cardiac disease group(heart qi deficiency)and 67 cases in the group of simultaneous illness in the heart and kidney(yang deficiency of the heart and kidney),to observe and compare the indexes of cardiac function,ANP, renin and angiotensin(AngⅡ)in the patients in the two groups and to explore the interrelation between pathogenesis of “simultaneous illness in the heart and kidney”and circulatory hormone in CHF patients.The results showed that the gradation and evaluation of the cardiac function in the group of simultaneous illness in the heart and kidney were remarkably higher than those in the cardiac disease group( P <0.001);ANP level in the cardiac disease group was obviously elevated and ANP and RAS indexes in the group with simultaneous illness in the heart and kidney were obviously elevated,with a significant difference( P <0.001)in comparison of the cardiac disease group.These results indicate that elevation of ANP plasma concentration is a sign of “syndrome of heart qi deficiency”,RAS activity shows pathogenesis of“simultaneous illness in the heart and kidney”.The above indexes can also be taken as one of the basis for judgement of CHF condition and evaluation of the drug effect.更多还原