舒张性心力衰竭患者血浆脑钠肽与超敏C反应蛋白水平及治疗前后的变化

Variations of the levels of plasma brain natriuretic peptide and hypersensitive C reactive protein before and after treatment in patients with diastolic heart failure

目的探讨舒张性心力衰竭患者血浆脑钠肽（BNP）与超敏C反应蛋白（hs-CRP）水平的变化及临床意义。方法 48例（NYHY分级Ⅲ-Ⅳ级）舒张性心力衰竭患者为心衰组,其中Ⅲ级组30例,Ⅳ级组18例,分别于清晨空腹和心功能改善至Ⅰ-Ⅱ级后采血,测定血浆BNP和hs-CRP。选取30例体检健康者为对照组。结果心衰组BNP和hs-CRP均较对照组显著升高（P〈0.01）,且随心衰程度加重而升高（P〈0.01）。心衰组随着心功能的改善BNP和hs-CRP明显下降,与治疗前比较差异有统计学意义（P〈0.01）。结论舒张性心力衰竭时BNP和hs-CRP均升高,且随心功能损害加剧而增高明显,治疗后均明显降低,提示BNP和hs-CRP可能是反映舒张性心力衰竭病情变化的指标。

Objective To investigate the variations of the levels of plasma brain natriuretic peptide（BNP） and hypersensitive C reactive protein（hs-CRP） in patients with diastolic heart failure（DHF）.Methods 48 admitted patients with DHF were divided into class Ⅲ group（30 cases） and class Ⅳ group（18 cases） according to NYHA Functional Classification.Blood samples were taken in the morning（fasting blood） and when the heart function was improved to class Ⅰ to Ⅱ to determine the levels of plasma BNP and hs-CRP.30 healthy cases were designated as the healthy control group.Results The plasma levels of BNP and hs-CRP were higher in DHF groups than those in the healthy control group（P〈0.01）.The levels of BNP and hs-CRP were higher in patients of class Ⅳ group than those of class Ⅲ group（P〈0.01）.With the improvement of heart function and the evident decrease in the levels of BNP and hs-CRP in the DHF groups,the differences before and after treatment were statistically significant（P〈0.01）.Conclusion The levels of BNP and hs-CRP in DHF were high and increase with the severity of DHF and could be reversed by treatment,suggesting that BNP and hs-CRP could be indicators to the variations of the status of DHF.