收缩性和舒张性心力衰竭患者脑利钠肽水平的对比分析

Compare of plasma brain natriuretic peptide levels between the patients with systolic heart failure and diastolic heart failure

目的:探讨收缩性和舒张性心力衰竭患者血浆脑利钠肽(BNP)水平的差异和收缩性心力衰竭患者脉压与BNP水平的关系。方法:2005年10月至2006年7月在天津医科大学总医院心内科住院患者34例分为两组:收缩性心力衰竭组患者22例,舒张性心力衰竭组患者12例。采取静脉血测定血浆BNP浓度,行超声心动图检查,测量血压,计算脉压。结果:收缩性心力衰竭组的血浆BNP水平、左心室舒张末期内径(LVEDd)比舒张性心力衰竭组的高(P<0.05～0.001)。收缩性心力衰竭患者BNP水平与脉压、收缩压、左室射血分数(LVEF)呈显著负相关(分别r=-0.58,P<0.01;r=-0.50,P<0.05;r=-0.62,P<0.01),与LVEDd、右心室舒张末期内径(RVEDd)呈正相关(分别r=0.55,P<0.05;r=0.57,P<0.05)。结论:收缩性心力衰竭患者血浆BNP水平高于舒张性心力衰竭患者,其血浆BNP水平升高与脉压降低有关。

Objective： To observe the different of plasma BNP levels between the patients with systolic heart failure and diastolic heart failure, and correlation between pulse pressure and plasma BNP level in patients with systolic heart failure. Methods： A total of 34 patients from October 2005 to July 2006 in department of cardiology of Tianjin medical university affiliated hospital were divided into group 1 （systolic heart failure, n=22） and group 2 （diastolic heart failure, n=12）. The measurements of BNP, blood pressure and echocardiography examine were performed and the pulse pressures were calculated. Results： Plasma BNP concentrations and left ventricular end-diastolic dimension （LVEDd） of the systolic heart failure group were much higher than those of diastolic heart failure group （P〈0.05-0. 001）. The increase degree of BNP had a significantly negative correlations with pulse pressures （r=-0.58, P〈0.01） and systolic blood pressure （r=-0.50, P〈0.05） and LVEF （r= -0.62, P〈0.01）, and had a significantly positive correlations with LVEDd （r=0.55, P〈0.05） and RVEDd （r=0.57, P〈0.05）. Conclusion.. Plasma BNP concentrations of the systolic heart failure group were much higher than that of diastolic heart failure group. Levels of BNP is related to decreased pulse pressures in patients with systolic heart failure.