B-型钠尿肽在慢性充血性心力衰竭诊疗中的临床应用

B type natriuretic peptide apply for dignosis and treatment in patients with congestive heart failure

目的研究慢性充血性心力衰竭患者血浆B-型钠尿肽水平的变化及其与心功能状态、心脏结构的关系,探讨其用于慢性充血性心力衰竭诊断价值。方法按美国NYHA心功能分级标准,随机抽取心功能Ⅱ级、Ⅲ级、Ⅳ级内科住院患者共96例,先测定血浆BNP的含量,待慢性充血性心力衰竭患者经治疗症状缓解后同法测上述指标,并进行数据分析;心脏彩色多普勒超声诊断仪测量左室结构和功能。结果不同心功能分级患者的血浆BNP水平差异具统计学意义,经抗心衰治疗后,患者心衰症状缓解,BNP含量下降,BNP的变化有统计学意义。血浆BNP水平和LVEF呈负相关(γ=-0.37,P<0.05),与左室舒张末期内径(LVEDD)呈正相关(γ=0.36,P<0.05)。结论血浆BNP水平和心脏结构相关,是慢性充血性心力衰竭诊断、治疗疗效评价的敏感指标。

Objective This study was performed to explore the correlation among plasma levels of B type natriuretic peptides（BNP） and the left ventricular function and structure in patients with chronic heart failure （CHF）, and to evaluate the value of plasma levels of B type natriuretic petides in the CHF diagnosis. Methods According to NYHA Class ,96 patients on random were selected. They were assigned to groups , NYHA Ⅱ, NYHA Ⅲ ,and NYHA Ⅳ.BNP plasma levels were measured just before treatement and after treatement in improvement of patients＇s symptom. Datas was analyzed among patients with NYHA. Doppler echoear-diography was perfoimed to measure left ventricular function and structure. Results Significant differences existed BNP level among NYHA Class.BNP level was significantly lower after treatment.Improvement of patients＇s symptom was positively correlated to the change of BNP level （P〈0.05）. plasma level of BNP had a negative correlation with LVEF（T=-0.37,P〈0.05）and BNP plasma level had a positive correlation with left ventricular end-diastolic diameter （T=0.36,P〈0.05）. Conclusion BNP level had close relationship with left ventricular structure. Measuring of plasma BNP level might be a sensitive biomarker in diagnosis and treatment of congestive heart failure.