B型利钠肽和N-末端B型利钠肽原水平的影响因素及其不同点

Factors associated plasma B type natriuretic peptide and N-terminal pro-B-type natriuretic peptide levels

目的探讨与B型利钠肽（BNP）相关的临床因素，及这些因素对BNP和N-末端B型利钠肽原（NT—proBNP）的不同影响。方法对1983名体检者进行常规血液检查，血压测量，心电图检查，并检测BNP和NT-proBNP水平，后用多变量回归分析分别检验血浆BNP和NT-proBNP水平与各因素的相关性。结果BNP和NT-proBNP呈正相关。与BNP显著相关的因素依次为：年龄、血红蛋白、脉搏、收缩压、总胆固醇、性别、甘油三酯、肌酐。与NT-proBNP显著相关的因素依次为：年龄、肌酐、血红蛋白、性别、甘油三酯、总胆固醇、收缩压、脉搏。这些因素对BNP和NT—proBNP的影响有所不同：NT-proBNP受肾功能及性别影响较大，而BNP可能受自主神经影响较明显。在收缩压亚组，BNP和NT—proBNP水平在各组间差异有统计学意义。在年龄亚组，组间比较差异也有统计学意义。性别与BNP水平密切相关，女性的BNP水平显著高于男性。结论BNP和NT—proBNP与年龄、血压、肌酐、脉搏、性别及血脂密切相关。然而，这些因素对两者的影响有所不同。

Objective To identify factors closely associated with plasma B type natriuretic peptide （BNP） and N-terminal pro-B-type natriuretic peptide （NT-proBNP） levels. Methods A total of 1983 people （mean 66 years-old and 694 male） underwent annual health check-up in 2006 in Okuizumo district were included in this study. Blood pressure, electrocardiogram, conventional blood examination, plasma BNP and NT-proBNP were measured. Results BNP is positively correlated with NT-proBNP （ r = 0. 89, P〈0.01）. Multiple regression analysis showed that age, Hb, pulse rate, SBP, TC, gender, TG and creatinine were significantly related to BNP and age, creatinine, Hb, gender, TG, TC, SBP, pulse rate were significantly related to NT-proBNP. NT-proBNP was more easily affected by renal function changes and BNP was more easily affected by autonomic nervous system changes. Both BNP and NT-proBNP significantly increased in proportion to SBP and age. NT-proBNP and BNP were significantly higher in females compared with males （all P 〈 0. 05 ） . NT-proBNP and BNP were also negatively correlated with abdominal circumference （all P 〈 0. 05 ）. Conclusion In this study population, NT-proBNP and BNP were closely associated with age, blood pressure, creatinine, pulse rate, lipid levels, gender and abdominal circumferences.