慢性心力衰竭患者血浆脑利钠肽、内皮素-1水平与心功能状态的关系

Plasma level change of brain natriutetic peptides, Endothelin-1 in patients with chronic heart failure

目的研究慢性心力衰竭(CHF)患者血浆脑利钠肽(BNP)、内皮素-1(ET-1)水平的变化及其与心脏功能的关系。方法以慢性心力衰竭组48例作为研究对象,根据NYHA标准分级:Ⅱ级16例,Ⅲ级19例、Ⅳ级13例。采用酶联免疫吸附试验(ELISA法)测定血浆BNP水平,放射免疫法测定血浆ET-1水平,并以38例健康人作为对照组进行比较研究。结果心衰组血浆BNP、ET-1水平较对照组均显著增高(P<0.01),并且随着NYHA心功能分级的增高而逐级升高。血浆BNP、ET-1水平均LVEF呈负相关(r=-0.532,r=-0.567,P<0.001),而且BNP与ET-1之间呈正相关(r=0.543,P<0.001)。结论在CHF患者中BNP与ET-1均可反映心衰的严重程度,其中血浆BNP水平更为敏感;血浆BNP和ET-1不仅可以反映心脏功能状态,而且两者在CHF的病理生理过程中有一种相互影响的关系。

[Objective] To explore the relationship between Plasma level of brain natriuretie peptides （BNP）, Endothelin-1 （ET-1） and left ventricular function in chronic heart failure（CHF） patients. [Methods] Study of relationship between BNP and ET-1 of plasma and heart function： 48 cases of chronic heart failure group, according to the New York Heart Association （NYHA） standard were slected. These cases were classified as 16 cases NYHA Ⅱ, 19 cases NYHA Ⅲ and 13 cases NYHA Ⅳ. Plasma level of BNP was measured by ELISA and ET-1 was measured by radio immunity, and 38 healthy persons were selected as control group. [Result] The plasma level of BNP, ET-1 is significantly increased compared to control group （P 〈0.001） and gradually increasing as NYHA heart function classification upgraded; there is significant difference （P 〈0.01） of BNP and ET-1 among different classification. Plasma level of BNP and ET-1 appears negative correlation with LVEF （r =-0.532,r =-0.567, P 〈0.001）, and exists certain positive correlation between BNP and ET-1 （r =0.543, P 〈0.001）. [Conclusion] For CHF cases, BNP and ET-1 could reflex the severe degree of heart failure, BNP can be an indicator for initial screening asymptomatic heart failure. The plasma level of BNP increasing can be used in the early diagnosis of heart failure. During the treatment of CHF eases, following-up the plasma level of BNP and ET-1 can be helpful to reflex the heart function status and evaluate curative effect. BNP and ET-1 can not only reflex heart function status, but also exist inter-restriction and interference in the Dathoohvsiological Dreeess of CHF eases.