B型脑钠肽在心力衰竭诊断和治疗中的意义

Utility of B-Type Natriuretic Peptide in the Diagnosis and Treatment of Congestive Heart Failure

B型脑钠肽是心室在容量或压力负荷下分泌的一种神经内分泌激素。临床试验证实,它可作为慢性心功能不全的诊断和鉴别诊断的指标,其血清浓度变化可以预测药物和器械治疗的疗效和预后。基于BNP生理作用开发的药物--奈西利肽,已被美国FDA批准用于失代偿期心衰的治疗,其短期疗效已由诸多临床试验证实,但能否改善远期预后以及对于失代偿期心衰患者肾功能的影响等方面,仍然受到质疑,需要更多的临床研究进一步探究。

B-Type Natriuretic Peptide is a kind of neuro-endocrine hormone secreted by ventricular cells burdened by volume or pressure load. Demonstrated by large scale clinical trials, the plasma level of it can be considered as a biochemical marker for diagnosis and differential diagnosis of congestive heart failure, and also for the efficacy evaluation and prognosis assessment during traditional drug or implanted instrumental treatment. Nesiritide,a drug developed basing on the physiological mechanism, has been approved in treating decompensated heart failure patients clinically by FDA. Although the short-term effect was confirmed by many clinical researches, dessents still rise on whether the long-term prognosis can be altered and the adverse influence on renal function of decompensated heart failure patients, remaining to be explored by further study.