血浆脑钠肽和血清肌钙蛋白I在老年慢性心力衰竭中的临床研究

Changes and Clinical Signii cance of the Level of Plasma Brain Natriuretic Peptide and Carolic Troponin I in Patients with Heart Failure

目的 探讨血浆脑钠肽（BNP）及血清肌钙蛋白I（cTNI）含量改变在老年患者发生充血性心力衰竭时的临床意义。 方法 选择2010年7月－2012年8月住院的各种老年心脏病患者117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BNP、血清cTNI及心肌酶[肌酸磷酸激酶（CK）、肌酸磷酸激酶同工酶（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级组血清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清cTNI水平差异无统计学意义。 结论 血浆BNP水平及血清cTNI水平在老年患者发生心力衰竭时随心力衰竭程度加重而逐渐升高，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。

Objective To investigate the change and its clinical significance of the level of plasma brain natriuretic peptide （BNP） and carolic troponin I （cTNI） in patients with heart failure. Methods A total of 117 elderly patients with various chronic heart failure treated in our hospital between July 2010 and August 2012 were included in our study. The patients were divided into four groups based on New York Heart Association classification. Another 40 old healthy people were designated as the control group. BNP, cTNI, creatine kinase （CK）, creatine kinase isoenzyme-MB （CK- MB） were measured and compared among the groups. Results For patients with chronic congestive heart failure （heart function II - IV ）, their plasma BNP level was higher than that in the control group and patients with normal heart function, and cTNI level of heart function IV patients was higher than that in patients with class-Ill heart function which in turn was higher than that in patients with class II heart function, and the difference was significant. But the cTNI level of patients with normal heart function and in those controls was not significantly different. CK and CK-MB level was not significantly different among all the groups. Conclusion Both the levels of BNP and cTNI increase with the aggravation of heart function gradually, and they have an important diagnosis value for chronic heart failure in elderly patients.