B型钠尿肽与TNF-α联合检测对充血性心力衰竭诊断价值的探讨

Diagnostic value of B-type natriuretic peptide and TNF-α combined detection in patient with congestive heart failure

目的探讨B型钠尿肽与TNF-α联合检测对充血性心力衰竭的诊断价值。方法 70例慢性心衰患者均给予常规治疗,包括吸氧、强心、利尿、扩血管等支持治疗,另选28例健康体检者作为对照组,全部入院对象分别采用全血快速微柱层析法检测定BNP,采用放射免疫法测定TNF-α,比较不同心功能分级及对照组的B型钠尿肽与TNF-α的浓度变化。结果两组TNF-α和BNP的浓度均随着心功能分级的增加而逐渐增加,即随着心功能的下降而逐渐升高。其中心功能Ⅳ级组的TNF-α和BNP的浓度均分别高于心功能Ⅲ级组、心功能Ⅱ级组、心功能I级组,而心功能Ⅲ级组还高于心功能Ⅱ级组、心功能I级组,差异均有统计学意义(P<0.01)。CHF患者BNP与TNF-α呈正相关(r=0.247,P<0.01),且随着心功能分级程度的加重及疾病的进展,血清BNP与TNF-α的相关性增强。结论心力衰竭患者的BNP、TNF-α的水平与心力衰竭的严重程度密切相关,二者共同参与了CHF的病理生理过程,B型钠尿肽与TNF-α联合检测有利于充血性心力衰竭的诊断及病情严重程度的判断。

Objective To investigate the diagnostic value of B-type natriuretic peptide and TNF-α combined detection in patient with congestive heart failure （CHF）. Methods 70 patients with CHF were given conventional treatment, including oxygen, cardiac, diuretic, vasodilator and other supportive therapy. 28 cases of healthy subjects were as the control group. The BNP was detected using whole blood rapid micro-column chromatography, the TNF-α was detected using radioimmunoassay. The changes of B-type natriuretic peptide and TNF-α in different cardiac function and control group were analyzed. Results The TNF-α and BNP levels increased with the grade of cardiac function gradually increasing, in other words, with the decline in cardiac function gradually increased. The TNF- a and BNP concentrations of the class IV cardiac function group were greater than class Ⅲ cardiac function group, class Ⅱ cardiac function group and class Ⅰ cardiac function group, while class Ⅲ cardiac function group were greater than class n cardiac function group and class Ⅰ cardiac function group, the differences were significant （ P 〈 0.01 ）. BNP and TNF-α levels of CHF patients were positive correlation （ r = 0. 247, P 〈 0.01 ）, and with the severity of cardiac function classification and progression of the disease, the serum BNP and TNF-α. had more closely correlation. Conclusion The BNP and TNF-α level of CHF patients have more closely correlation with the severity of cardiac function, their common participation in the pathophysiology of CHF. B-type natriuretie peptide and TNF-α combined detection are help to diagnosis of CHF and judgments of severity.