充血性心力衰竭与肺源性心脏病患者血浆BNP水平的比较

Comparison of plasma levels of brain natriuretic peptide in patients with congestive heart failure or lung-derived heart disease

目的:比较充血性心力衰竭(congestive heart failure,CHF)及肺源性心脏病(pulmonary heart disease,PHD)患者急性呼吸困难发作时及缓解后1周血浆脑钠尿肽(BNP)水平的变化并分析其临床意义。方法:采用全血化学发光法测定CHF及PHD患者急性呼吸困难发作时及缓解后1周血浆BNP水平。结果:CHF患者呼吸困难发作时血浆BNP水平明显高于病情缓解后1周血浆BNP水平[(1997±865)ng/L vs.(184±114)ng/L,P<0.05],PHD患者呼吸困难发作时血浆BNP水平明显高于病情缓解后1周血浆BNP水平[(679±202)ng/L vs.(145±48)ng/L,P<0.05],呼吸困难发作时CHF组患者血浆BNP水平明显高于PHD组(P<0.05),呼吸困难缓解后1周两组间无显著差异。结论:BNP水平可作为CHF患者病情严重程度及疗效判断的评价指标。也可作为临床协助鉴别CHF呼吸困难与PHD重度肺功能不全呼吸困难的检测指标之一。

AIM： To compare the changes of plasma brain natriuretic peptide（BNP） levels in patients with congestive heart failure（CHF） or lung-derived heart disease（pulmonary heart disease,PHD） with dyspnea at onset and 1 week after remission.METHODS： Using the whole blood chemiluminescence method,plasma BNP levels in patients with dyspnea were determined at onset and 1 week after remission.RESULTS： At the onset of dyspnea in patients with CHF,plasma BNP levels were significantly higher than those 1 week after remission [（1997±865） ng/L vs.（184±114） ng/L,P0.05].Likewise,at the onset of dyspnea in patients with PHD,plasma BNP levels were also significantly higher than those 1 week after remission [（679±202） ng/L vs.（145±48） ng/L,P0.05].However,at the onset of dyspnea,plasma BNP levels in patients with CHF were significantly higher than those in patients with PHD（P0.05）,but no significant difference was observed between groups at 1 week after remission.CONCLUSION： BNP levels reduce with dyspnea remission.BNP levels can serve as an index in evaluating clinical severity and therapy results.At onset of dyspnea in patients with CHF,the BNP level is significantly higher than in patients with PHD,which can possibly be used clinically in differentiating dyspnea of CHF from PHD.