冠状动脉粥样硬化性心脏病合并充血性心力衰竭患者血浆脑钠肽水平的检测

Detection of the levels of plasma brain natriuretic peptide in patients with coronary heart disease and congestive heart failure

目的测定冠状动脉粥样硬化性心脏病(CHD)合并充血性心力衰竭(CHF)患者血浆中脑钠肽(BNP)的含量,探讨BNP含量的变化与冠心病心力衰竭患者的关系。方法应用荧光免疫测试仪测定观察组140例冠心病心力衰竭患者血浆中脑钠肽含量,心脏多普勒测量左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及测量心胸比,同时观察心律失常的发生及类型,与对照组30例进行对照分析。结果140例冠心病心力衰竭患者血浆中脑钠肽含量(865.6±590.9)pg.mL1,明显高于对照组的(26.1±5.2)pg.mL-1(P<0.01)。心功能II级组、心功能III级组、心功能IV级组血浆BNP含量均较对照组明显升高(P<0.05),心功能III级组、心功能IV级组BNP含量明显高于心功能II级组(P<0.01),心功能IV级组血浆BNP含量明显高于心功能III级组(P<0.05);心功能III级组、心功能IV级组与心功能II级组相比,左室舒张内径、心胸比增大(P<0.01),LVEF下降(P<0.01);心功能IV级组与心功能III级组相比,左室舒张内径、心胸比增大(P<0.05),LVEF下降(P<0.05)。心功能IV级病例组中,窦性心动过速、心房颤动、室内传导阻滞、三度房室传导阻滞者两两比较BNP的含量均有显著差异(P<0.01)。结论血浆中BNP含量可反映冠心病心力衰竭患者心功能的状态和分级。

Objective To detect the content of plasma brain natriuretic peptide （BNP） in patients with coronary heart disease（CHD） and congestive heart failure（ CHF）, and to estimate the relationship between change of plasma BNP and CHF. Methods The content of plasma BNP in 140 patients with CHF and CHD was detected by immunologic fluorescenee detector. Left ventricular ejection fraction（LVEF） and left ventricular end-diastolic dimension and （LVEDD） were detected by Doppler. The type of arbythmia was observed. The contrast analysis between the observation group and control group was carried out. Resuits The content of plasma BNP in observation group （ 865.6 ± 590.9 ） pg . mL^-1 was obviously higher than this in control group（26.1 ± 5.2 ） pg . mL ^- 1 （ p 〈 0.01 ）. With the aggravation of congestive heart failure, content of BNP in plasma rised up gradually in cardiac function Ⅱ group and cardiac function Ⅲ group or cardiac function Ⅳ group（ P 〈 0.05, ） , LVEDD rised up gradually in cardiac function Ⅱ group and cardiac function Ⅲ group or cardiac function Ⅳ group（ P 〈 0.05 or P 〈 0.01 ） , LVEF and descended between cardiac function Ⅱ group and cardiac function Ⅲ group or cardiac function Ⅳ group（ P 〈 0.0l ）. Among 55 patients with cardiac function Ⅳ, there was significant deviation in BNP among the patients with sinus tacbycardia, atrial fibrillation, intraventricular conduction blockade or third degree atrioventricular block （ P 〈 0.01 ）. Conclusion BNP in plasma may be reflect the grading and state of heart function in patients with congestive heart failure and coronary heart disease.