慢性心力衰竭患者代偿期血浆利钠肽激素生物变异性的对照分析

The intraindividual variability of natriuretic peptides in patients with chronic heart failure

目的观察慢性心力衰竭患者血浆利钠肽激素系列的变异程度。方法该研究入组对象为46例慢性心力衰竭代偿期患者。在入组时以及1周后各抽取2份血样,测定其血浆脑利钠肽(BNP)及N末端脑利钠肽(NT-proBNP)。并进行当次的小时间及周间的变异系数的计算,然后利用公式得出参考变异值(RCV),从而判断出该组患者BNP及NT-proBNP的生物变异程度。结果该组患者的BNP在入组当天的小时间及1周时的变异程度分别为:BNP13.8%和27.6%,NT-proBNP7.2%和22.4%,BNP及NT-proBNP在入组时的小时间变异比较差异无统计学意义,P<0.01。经过分析得出1周时间内该组患者NT-proBNP与BNP的RCV分别为50.3%及64.8%。同时研究中发现利钠肽激素的变异程度与年龄、性别及内生肌酐清除率无关。结论慢性心力衰竭患者代偿期利钠肽激素的个体生物变异性较大。临床上要更准确地监测慢性心力衰竭患者的治疗反应或病情变化时需要将其考虑在内。

Objective This study evaluates the intraindividual variability of BNP and NT-proBNP in stable heart failure （HF） patients. Methods Forty-six stable HF patients attending our unit were included. Two blood samples were drawn at the beginning and 1-week time respectively. Within-hour and within-week intraindividual variability were taken. Then reference change values （RCV） over 1 week for NT-proBNP and BNP were got respectively. Results Within-hour and within-week intraindividual variability were： 13.8% and 27.6% for BNP, 7.2% and 22.4% for NT-proBNP respectively; （P〈 0.01 for within hour comparison of BNP and NT-proBNP）. Reference change values over 1 week for NT-proBNP and BNP were 50.3% and 64.8%, respectively. There were no significant relationships identified between variability and age, gender, or glomerular filtration rate. Conclusion There is considerable intraindividual variability in these peptides in stable HF patients.