B型利钠肽在心力衰竭患者临床评估中的作用

Clinical evaluation effect of brain natriuretic peptide in patients with heart failure

目的:研究B型利钠肽(BNP)检测在慢性心力衰竭(CHF)患者的诊断、病情评估等方面的临床价值。方法:选取2004年6月～2005年1月在我院住院的60例CHF患者(CHF组)及同期住院经冠状动脉造影、超声心动图及其他检查证实无器质性心脏病的患者20例(对照组)。采用酶联免疫吸附法(ELISA)测定患者血浆BNP水平,应用美国GE公司VIVED7彩色多普勒超声诊断仪测定相关参数及左室功能。分析BNP水平与患者心功能状态、心脏超声指标的关系。结果:CHF组患者血浆BNP水平为(96.49±85.73)pg/ml,显著高于对照组(5.79±4.22)pg/ml(P<0.001);在纽约心脏病学会(NYHA)心功能分级的不同亚组间血浆BNP水平分别为:(22.40±9.72)、(47.77±20.03)、(88.38±35.87)、(184.69±92.93)pg/ml,差异均具有统计学意义。血浆BNP水平随着NHYA心功能分级的增加而显著升高;与左室射血分数(LVEF)呈显著负相关(r=-0.675,P<0.001),与左室舒张末径(LVEDD)呈显著正相关(r=0.682,P<0.001)。结论:心力衰竭患者血浆BNP水平随着心力衰竭严重程度的增加而升高,并能较好反映左室功能状态,可作为一种简便快速的手段用于CHF的诊断及危险分层。

Objective: To explore the clinical value of plasma brain natriuretic peptide(BNP) on the diagnosis and clinical evaluation on patients with chronic heart failure(CHF). Methods: 60 patients with heart failure and 20 patients without cardiopathy according to the results of coronary artery angiography, echocardiography and other examination were enrolled from June 2004 to Jan 2005. BNP levels were measured by ELISA. Colored Doppler echocardiography was performed to measure the left ventricular function and the correlating parameters. Analyze the correlation between BNP level, the state of cardiac function and the echocardiography markers. Results: BNP level in CHF group was markedly higher than that in control group(96.49±85.73)pg/ml vs(5.79±4.22)pg/ml(P<0.001); in different NYHA functional classes were (22.40±9.72) pg/ml, (47.77±20.03) pg/ml, (88.38±35.87) pg/ml, (184.69±92.93) pg/ml respectively, and there were statistical significance among them.Serum BNP level increased significantly with incremental NYHA functional classes;and had a negative correlation with LVEF(r=-0.675, P<0.001), a positive correlation with LVEDD(r=0.682, P<0.001). Conclusion: Serum BNP level in patients with CHF elevated significantly with the severity of heart failure and can better reflect the left ventricular function. It can be served as a effective marker of the diagnose and risk stratification in CHF.