慢性充血性心力衰竭时血浆脑钠肽和肌钙蛋白I的含量改变

Changes of the level of the plasma brain natriuretic peptide and carolic troponin I in patients with chronic heart failure

目的:探讨老年心脏病患者发生充血性心力衰竭时血浆脑钠肽(BNP)及肌钙蛋白Ⅰ(cTNI)含量改变及临床意义。方法:选择2006-01-2011-03在我院住院的各种老年心脏病患者235例,根据纽约心功能分级,分为4组(心功能Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组),分别检测血浆脑钠肽、肌钙蛋白I及心肌酶(CK、CK-MB),进行组间比较,同时与健康老年组进行对比。结果:①老年心脏病慢性充血性心力衰竭各组(心功能Ⅱ～Ⅳ级)血浆BNP水平均高于健康对照组及心功能正常组(心功能Ⅰ级组);且心功能Ⅳ级组BNP水平>心功能Ⅲ级组>心功能Ⅱ级组。各组之间比较,差异有统计学意义。但心功能Ⅰ级组与健康对照组血浆BNP水平无明显差异。②各组之间CK及CK-MB水平差异均无统计学意义。③充血性心力衰竭各组(心功能Ⅱ～Ⅳ级)血浆cTNI水平均高于健康对照组及心功能正常组(心功能Ⅰ级组);且心功能Ⅳ级组cTNI水平>心功能Ⅲ级组>心功能Ⅱ级组。各组之间比较,差异有统计学意义。而心功能Ⅰ级组及健康对照组血浆cTNI水平差异无统计学意义。结论:血浆BNP水平及肌钙蛋白水平在老年人不同程度的充血性心力衰竭时均较正常人及慢性心脏病患者心功能正常时增高,且心功能损害程度越重,血浆BNP及肌钙蛋白I水平越高。两者均对慢性充血性心力衰竭的临床诊断具有重要参考意义。在临床诊断过程中,如能结合临床表现及其他检查结果,同时参考血浆BNP及肌钙蛋白水平,将会明显增加对慢性充血性心力衰竭诊断的及时性及正确性。

Objective：To investigate the changes and clinical significant of the level of the plasma brain natriuretic peptide（BNP） and carolic troponin I（cTNI） in the patients with heart failure.Method：235 patients with chronic heart failure were selected in this study.All the patients were divided into four groups in accordance of NYHA.40 healthy men were as control group.Blood samples were collected in the morning and BNP,CK,CK-MB and cTNI were measured.Compare all the index of one group with other group.Result：Both the level of the BNP and cTNI increased in the groups of the chronic heart failure（NYHAⅡ~Ⅳ group）.However,there was no difference between the control group and the group of normal heart function group（NYHA Ⅰ group）.Conclusion：Both the level of the BNP and cTNI all increased with aggravate of heart function gradually and they have important consult diagnosis value to the chronic heart failure in elderly patients.