心衰患者血浆B-型钠尿肽水平的研究

摘要

Objective: To investigate the relationship between plasma level of B type natriuretic peptide (BNP) and changes of cardiac function in patients with heart failure (HF). Methods: Plasma levels of BNP were measured in 43 HF patients (HF group) and 38 healthy subjects (normal control group). NYHA cardiac function classification and ultrasonic cardiogram parameters were used to compare left cardiac function of the two groups. After two-week comprehensive treatment with anti—HF drugs, plasma level of BNP and cardiac function indexes such as left ventricular e-jection fraction (LVEF) of HF group were detected and compared with those of before treatment. Results: As cardiac function aggravated, plasma level of BNP significantly increased [NYHA class I : (156. 15±71. 42) pg/ml vs. NY-HA classⅡ: (405. 42±263. 38) pg/ml vs. NYHA classⅢ: (736.12±395. 47) pg/ml vs. NYHA classⅣ: (1106. 36 ±582. 33) pg/ml, P＜0. 05] . After comprehensive treatment with anti—HF drugs, BNP levels of all cardiac function classes significantly decreased compared with before treatment (P＜0. 01) . BNP level was negatively related with LVEF (r=—0. 578) and left ventricle fraction shortening (r=— 0. 542) ; it's positively correlated with left ventricular end—diastolic dimension (r=0. 611) and cardiothoracic ratio (r=0. 534). P＜0. 05 all. Conclusion: Plasma level of BNP is closely related to the severity of heart failure. Measurement of plasma level of BNP in patients with heart failure is an effective method to monitor the severity of heart failure.%目的:探讨血浆B-型利钠肽(BNP)水平与心力衰竭患者心功能变化之间的关系.方法:测定43例心力衰蝎患者(HF组)与38例健康体检者(正常对照组)血浆BNP含量,采用NYHA心功能分级法进行分级和超声心动图测定两组左心功能参数,并进行比较;HF组进行抗心衰药物综合治疗2周,然后就其血浆BNP水平及左室射血分数(LVEF)等心功能指标与治疗前进行比较.结果:随着心功能恶化,血浆BNP水平呈上升趋势,各级心功能间差异均有显著性[NYHAⅠ级:(156.15±71.42)pg/ml比NYHAⅡ级:(405.42±263.38)pg/ml比NYHAⅢ级:(736.12±395.47)pg/ml比NYHAⅣ级:(1106.36±582.33)pg/ml,P<0.05].经抗心衰药物综合治疗后,各心功能等级BNP水平较治疗前明显降低(P<0.01).BNP水平与LVEF(r=-0.578)、左心室短轴缩短率(r=-0.542)呈负相关;与左室舒张末内径(r=0.611)、心胸比率(r=0.534)呈正相关(P均<0.05).结论:血浆B-型利钠肽水平与心衰程度密切相关,测定心衰患者血浆B-型利钠肽水平是监测心衰程度的有效手段之一.