肺源性心脏病心力衰竭患者BNP、CRP变化水平及其临床意义

Changes in levels of BNP and CRP in patients of chronic pulmonary heart disease with cardiac failure and its clinical significance

目的探讨肺源性心脏病不同程度心力衰竭患者脑钠肽(BNP)和C反应蛋白(CRP)的变化及其临床意义。方法将158例肺源性心脏病患者进行心功能分级,分别为Ⅰ级、Ⅱ级、Ⅲ级和Ⅳ级,应用双抗夹心免疫酶法与胶乳凝集反应法测定所有患者血浆BNP浓度及血浆C反应蛋白(CRP)浓度;心脏多普勒超声检查心脏左室射血分数(EF)、肺动脉平均压(MPAP)、右心室内径(RVID);胸部正位片测定右肺下动脉直径。结果血浆BNP随心衰程度的加重而显著增加,MPAP上升,RVID增加,EF下降,CRP增加,右肺下动脉直径增加,各级心功能组间的差异均有统计学意义(P<0.05)。结论肺源性心脏病患者血浆BNP浓度随着心衰程度加重而上升,与EF、MPAP、RVID、CRP、右肺下动脉直径等直接相关。

Objective To investigate the changes in the levels of brain natriuretic peptide（BNP） in patients of chronic pulmonary heart disease（CPHD） with different degrees of heart failure.Methods According to New York Heart Association（NYHA） functional classification,158 patients of CPHD were divided into four groups： gradeⅠ,gradeⅡ,gradeⅢ,and gradeⅣ.The concentration of BNP and C-reactive protein（CRP） were measured by ELISA and Latex Agglutination Method.The left ventricular ejection fraction（EF）,mean pulmonary artery pressure（MPAP）,and right ventricular internal diameter（RVID） were detected by heart Doppler Ultrasonic,and the diameter of the right lower pulmonary artery was measured by Chest X-ray.Results The levels of plasma BNP increased significantly as the degree of heart failure aggravated.At the same time,the levels of MPAP elevated significantly,with levels of RVID increased significantly,EF descended significantly,CRP increased significantly,and the diameter of the right lower pulmonary artery increased significantly（P〈0.05）.Conclusion The levels of plasma BNP in patients of CPHD increased significantly along with the aggravation of the heart failure,which showed a direct correlation with BNP,EF,MPAP,RVID,CRP,and the diameter of the right lower pulmonary artery.