血浆脑钠肽对心力衰竭诊断及预后判断的临床分析

Role of Blood Plasma Brain Natriuretic Peptide in Diagnosis and Prognosis of Patients with Heart Failure

目的探讨血浆脑钠肽(BNP)浓度水平对心力衰竭(HF)诊断及预后判定的作用。方法荧光免疫法测定93例呼吸困难患者血浆BNP浓度。心脏彩超测定心脏左室射血分数(LVEF)。符合Framingham心力衰竭诊断标准患者61例,按美国心功能分级标准(NYHA)进行心功能分级。HF患者根据出院时血浆BNP浓度分为BNP<400pg/ml(A)和BNP≥400pg/ml(B)两组,对两组患者因HF4周内再次住院率进行比较。结果 HF患者血浆BNP浓度(583±189)pg/ml明显高于非HF组(49±8)pg/ml。随着HF的加重其浓度逐渐升高,HF患者血浆BNP浓度与LVEF呈负相关(r=-0.67,P<0.01)。不同原发病患者血浆BNP浓度差异无统计学意义(P>0.05)。出院时血浆BNP浓度≥400pg/ml(B)组4周内再次住院率升高(P<0.05)。结论血浆BNP浓度变化可作为心衰诊断和预后判断的一项临床便捷指标。

Objective To investigate the role of blood plasma brain natriuretic peptide（BNP） in diagnosis and prognosis of pa- tients with heart failure（HF）. Methods The level of blood plasma BNP in 93 patients with dyspnea were detected by using the fluorescence immunoassay method. LVEF were determined by heart color Doppler test. 61 cases met the Framingham criteria for congestive heart failure. The functional classes were assessed by New York Heart Association（NYHA）. The patients with HF were divides into group A（ BNP 〈400 pg/ml） and group B（ BNP≥400 pg/ml） according to their blood plasma BNP levels. The rate of rehospitalization in d weeks was compared between the two groups. Results The blood plasma BNP levels of patients with HF was （583 ± 189）pg/ml, and obviously higher than that[ （49± 8 ）pg/ml ] of patients without HF, and it increased with the severi- ty. In HF patients,the blood plasma BNP had an inverse correlation with LVEF（ r = - 0. 67, P 〈 0.01 ）. There was no statistical significance in the difference of blood plasma BNP levels among the patients with different primary diseases（P 〉 0.05 ）. The rehospitalization rate of group B was higher than that of group A four weeks after the discharge （ P 〈 0.05 ）. Conclusion The blood plasma BNP levels can be referenced in the diagnosis and prognosis judgment of patients with HF.