脑钠肽及C反应蛋白在慢性肾衰竭并发慢性心力衰竭患者中的临床应用价值

Clinical application significance of BNP and CRP in the patients suffered chronic renal failure complicated with heart failure

目的探讨脑钠肽(BNP)及C反应蛋白(CRP)在慢性肾衰竭(CRF)并发慢性心力衰竭(CHF)患者中的诊断和判断预后的意义。方法选取CRF并发CHF患者40例作为观察组,CRF无CHF患者40例作为对照A组,另选取同期健康体检者40例作为对照B组,单纯CHF患者40例作为对照C组,检测并对比四组研究对象BNP、CRP水平及观察组患者在不同CKD分期、NYHA分级时BNP、CRP水平变化。结果观察组、对照C组患者BNP、CRP水平明显高于对照A组及对照B组,差异具有显著性(P<0.05),对照A组与对照B组组间比较差异无显著性(P>0.05),观察组与对照C组组间比较差异无显著性(P>0.05)。观察组患者相同CKD分期,不同NYHA分级的BNP、CRP水平随心功能分级升高而明显升高,差异具有显著性(P<0.05);相同NYHA分级、不同CKD分期时BNP、CRP水平随CKD分期升高无明显升高,差异无显著性(P>0.05)。结论血浆BNP、CRP水平检测对CRF并发CHF患者心功能的评估具有重要的临床意义。

Objective To investigate the signiifcance of diagnosis and prognosis of brain natriuretic peptide （BNP） and C-reactive protein （CRP） in patients with chronic renal failure （CRF） complicated with chronic heart failure （CHF）. Method Selected 40 patients of CRF with CHF as observation group;40 patients of CRF without CHF as control group A;40 healthy people as control group B;40 patients of CHF as control group C;tested and compared the levels of BNP and CRP in these four groups, and the changes of the levels of BNP and CRP in observation group in different period of CKD and NYHA. Result The levels of BNP and CRP in observation group and control group C were signiifcantly higher than those in control group A and group B, and there was signiifcant difference （P〈0.05）;there was no signiifcant difference between group A and B （P〉0.05）;there was no signiifcant difference between observation group and group C （P〉0.05）. In observation group, the patients’ BNP and CRP levels of the same CKD stage and different NYHA classiifcation increased obviously with the rise of heart function grade, and the difference was signiifcant （P〈0.05）;BNP and CRP levels of the same NYHA classiifcation and different CKD stages had no signiifcant rise with the rise of CKD stage, and there was no signiifcant difference （P〉0.05）. Conclusion The test of plasma BNP and CRP level has a great clinical signiifcance for the assessment of cardiac function of patients with CRF and CHF.