左心室舒张功能不全血清脑钠肽的改变及缬沙坦干预的作用

The change of serum brain natriuretic peptide concentration in left ventricular diastolic dysfunction and effect of valsartan on it

目的 探讨左心室(左室)舒张功能不全患者血清脑钠肽(BNP)水平改变和诊断价值,以及缬沙坦干预的作用。方法 用酶联免疫法测定30例单纯左室舒张功能不全患者(LVDD组)、20例左室收缩功能不全伴或不伴舒张功能不全患者(LVSD组)、20例心功能正常者(对照组)以及LVDD组缬沙坦干预10周后的血清BNP浓度。结果 LVDD组BNP水平明显高于对照组(186. 9pg/ml±125. 1pg/ml对68. 9pg/ml±29. 3pg/ml,P<0. 05),但明显低于LVSD组(186. 9pg/ml±125. 1pg/ml对879. 3pg/ml±453. 2pg/ml,P>0. 05 )。若左室收缩功能正常,BNP>120pg/ml判断单纯LVDD的敏感度为86. 7%,特异度为95%,阳性预告值为96. 3%,阴性预告值为82. 6%。缬沙坦治疗LVDD10周对BNP水平尚无明显影响(150. 1pg/ml±87. 5pg/ml对145. 9pg/ml±80. 2pg/ml,P>0. 05)。结论 血清BNP浓度在单纯LVDD患者亦明显升高,并有较好的诊断价值,缬沙坦治疗LVDD患者10周对BNP水平尚无明显影响。

Objective To investigate the change of serum brain natriuretic peptide(BNP)level in patients with left ventricular diastolic dysfunction(LVDD) and effect of valsartan on it .Methods BNP levels were measured by ELISA in 30 cases with pure left ventricular diastolic dysfunction (LVDD group),20 with left ventricular systolic dysfunction combining or not with diastolic dysfunction(LVSD group),and 20 with normal cardiac function (control group).Results BNP level in LVDD group was markedly higher than that in control group(186.9pg/ml±125.1pg/ml vs 68.9pg/ml±29.3pg/ml,P<0.05),but significantly lower than that in LVSD group(186.9pg/ml±125.1pg/ml vs 879.3pg/ml±453.2pg/ml,P<0.05).Giving normal left ventricular systolic function,BNP level >120pg/ml had a sensitivity of 86.7 percent,a specificity of 95 percent,a positive predictive value of 96.3 percent,and a negative predictive value of 82.6 percent for determining LVDD.No difference of BNP level was found between patients before and after 10-week treatment with valsartan.Conclusion Serum BNP level in LVDD has significantly elevated,and was a good determination for LVDD,on which no effect of 10-week valsartan treatment was found.