慢性充血性心力衰竭血浆血管活性水平及临床意义

Changes of plasma vasoactive peptides in chronic heart failure patients and its significance

目的:探讨慢性心力衰竭患者血浆B型利钠肽(BNP)、心钠素(ANF)、胱抑素C(CysC)的水平及临床意义。方法:选择70例CHF患者,按NA分级;20例健康者作为对照。采用放射免疫法检查BNP和ANF水平;采用免疫比浊法检查Cys C。比较不同心衰等级以及不同BNP水平的上述指标的变化。结果:CHF患者血浆BNP、ANF、CysC水平与对照比较显著升高(P<0.05),并随NYHA等级增高而升高(P<0.05)。与BNP<400pg/ml组比较,400pg/ml≤BNP<800pg/ml组和BNP≥800pg/ml组心力衰竭患者Cr、BUN水平显著增高(P<0.05);相反地,HDL水平显著降低。结论:血浆B型利钠肽(BNP)、心钠素(ANF)及胱抑素C参与了CHF的发生发展过程,联合测定其含量的变化,对CHF患者的诊断、评估及危险分层具有一定的临床意义。

Objective： To study the changes of levels of B-type natriuretic peptide（BNP）, atrial natriuretic factor（ANF）, and Cystatin C in patients with chronic heart failure and its clinical signical sgnificance. Methods： 70 patients with CHF were classified according to NYHAS heart function class criterion, and 20 cases of health people were served as control. The levels ofplama BNP and ANF were measured by radioimmunoassay. The level ofplama Cystatin C was detected by immunoturbidimetric Test. Compare the changes of the above indexes. Results： The levels of plasma BNP, ANF and Cys C in CHF group were significantly higher than those in the control group （P 〈 0.05）, and they elevated with the increase of the New York Heart Association Class（P 〈 0.05）. Compared with BNP〈400pg/ml group, the levels of blood BUN, Cr were significantly increased in the 400pg/ml≤ BNP〈800 pg/ml group and the BNP≥800pg/ml group; however, the level of HDL was significantly decreased. Conclusion： Plasma BNP, ANF, Cys C may involved in the whole development of chronic heart failure and the detection of them may bring more instructive information in diagnosis, disease severity assessment and risk stratification of CHF.