慢性心力衰竭失代偿患者血浆β-内啡肽与脑钠肽变化的意义

Plasma Concentration of Beta-endorphin and Brain Natriuretic Peptide in the Decompensated Chronic Heart Failure

目的探讨慢性心力衰竭(CHF)患者血浆β-内啡肽(β-EP)在诊断和预后中的意义。材料和方法 CHF患者71例,按NYHA心功能分级分为3组(Ⅱ-Ⅳ)。应用放射免疫法(RIA)测患者血浆β-EP浓度,采用床旁Triager BNP测定仪测定同期血浆脑钠肽(BNP)量。结果 CHF各组血浆β-EP和BNP含量与对照组相比显著性升高,并随心功能分级的增加呈上升趋势(p<0.01)。CHF组血浆β-EP与BNP呈显著性线性正相关(p<0.01);血浆β-EP和BNP水平与EF值及FS呈显著性线性负相关(p<0.01)。血浆中β-内啡肽含量越高则半年内心血管事件发生率越高(p<0.01)。结论血浆β-内啡肽和BNP的水平是诊断CHF的重要实验室指标,并可用于心功能及预后的评估。

Objective Evaluate the value of the changes of plasma beta-endorphin （13-EP） of decompensatedCHF patients. Methods The 71 hospitalized CHF patients were divided into 3 groups according to the NYHA degree of heart function. The plasma concentration of β-EP were measured by radioimmnuoassay and BNP were measured by bedside Triger BNP radimeter. Results The concentrations of plasma β-EP and BNP in heart failure groups were significantly higher with the control group, and there was remarkable difference among the heart failure groups. There was positively correlation between the plasma concentration of β-EP and BNP in CHF patients（ p 〈 0.01 ）, and there was significantly negative correlation between the concentration of β-EP and BNP with LVEF and FS（ p 〈 0. 01 ）. The concentrations of plasma β-EP has significant relationship with prognosis of heart failure patients（ p 〈 0. 01）. Conclusion The measurement of plasma β-EP and BNP can be used as a sensitive marker to diagnose decompensated heart failure and evaluate the degree of heart function and the prognosis of CHF.