老年心力衰竭患者心功能对血浆脑钠肽水平的影响

Effect of Heart Function on Plasma Brain Natriuretic Peptide Levels in Elderly Patients with Heart Failure

目的探讨血浆脑钠肽(BNP)水平与老年心力衰竭患者心力衰竭严重程度的关系。方法对33例老年心力衰竭患者[观察组,按美国纽约心脏病学会(NYHA)心功能分级:Ⅱ级7例,Ⅲ级20例,Ⅳ级6例]和32例健康老年人(对照组)清晨平卧抽血(患者于入院24 h内及出院时)3 mL,测定血浆BNP水平;超声心动图测定左室射血分数(LVEF)、左室舒张末期内径值(LVEDD)。比较2组及心功能衰竭各亚组间血浆BNP水平。结果观察组LVEF值低于对照组、LVEDD及血浆BNP水平高于对照组(P<0.05或P<0.01)。心力衰竭发作时,观察组中心功能Ⅲ、Ⅳ级组的血浆BNP水平显著高于心功能Ⅱ级组(均P<0.05)。结论老年心力衰竭患者血浆BNP水平增高程度与心力衰竭的严重程度呈正比,可以作为评定心力衰竭进程和预后的指标。

Objective To investigate the relationship between plasma levels of brain natriuretic peptide （BNP） and severity of heart failure in elderly patients. Methods Blood samples were drawn within 24 hours of admission and at discharge from hospital to detect plasma BNP levels in 33 elderly patients with heart failure （observation group; 7 patients NYHA class II, 20 patients NYHA class llI and 6 patients NYHA class IV） and 32 healthy elderly subjects （control group）. Left ventricular end- diastolic diameter （LVEDD）and left ventricular ejection fraction （LVEF）were measured by echocard- iography. Plasma BNP levels were co class subgroups. Results Compared plasma NYHA mpared between the two groups, as well as among different NYHA with control group, LVEF significantly decreased but LVEDD and BNP levels significantly increased in observation group （P〈0.05 or P〈0.01 ）.Compared with class 11 subgroup, plasma BNP levels obviously increased in NYHA class 111 and IV subgroups （P〈0.05）. Conclusion Plasma BNP levels were positively correlated with the severity of heart failure in elderly patients. Therefore, plasma BNP levels can be used as the indicators for assessing the process and prognosis of heart failure.