BNP在心力衰竭诊治中的临床价值

Clinical Value of BNP in the Diagnosis and Treatment of Heart Failure

目的探讨B型利钠肽(BNP)在心力衰竭患者诊治中的临床价值。方法应用全自动免疫荧光实验方法测定患者血浆BNP含量,根据心力衰竭级别不同进行分类统计,观察各级别心力衰竭患者BNP水平并随访10个月比较各组患者再入院率及转归情况。结果 170例心力衰竭患者中,55例Ⅰ级患者BNP水平为65±6.3pg/ml;45例Ⅱ级患者BNP结果 107±9.4pg/ml;40例Ⅲ级患者BNP结果为213±11.2pg/ml;30例Ⅳ级患者BNP结果为378±24.7pg/ml;Ⅲ级患者BNP水平较Ⅰ级、Ⅱ级患者差异有统计学意义(P<0.01);Ⅳ级患者BNP水平较前三者差异有统计学意义(P<0.01);22例心力衰竭患者BNP结果超过400pg/ml时,其6个月内再入院比率54.5%(12/22)显著高于148例BNP结果在210pg/ml之下的患者之再入院率4.1%(6/148)(P<0.01)。结论血浆BNP水平可以作为判定心力衰竭程度和预后的重要参考指标。

Objective To investigate clinical value of Plasma Natriuretic Peptide（BNP） in the diagnosis and treatment of heart failure.Methods The level of BNP in plasma were detected by automatic immunofluorescence assay method.They were classified into groups depending on the level of heart failure.Level of BNP and readmission rate and situation of outcomes of patients in All groups were surveyed and followed up for 10 months.Results In 170 cases of heart failure patients,the mean BNP of 55 cases of patients with stage Ⅰ was 65 ± 6.3pg/ml;the mean BNP of 45 cases of patients with stage Ⅱ was 107 ± 9.4pg/ml;the mean B NP of 40 cases of patients with stage Ⅲ was 213 ± 11.2pg/ml;the mean BNP of 30 cases of patients with stage Ⅳ was 378 ± 24.7pg/ml.The BNP level of stage Ⅲ had statistical difference as compared to which of stage Ⅱ and Ⅲ（P ＜ 0.01）.The statistical difference of the BNP level of stage Ⅳ was meaningful as compared to the first three groups（P ＜0.01）.When the BNP level was more than 430pg/ml,the readmission rate of 57 cases of patients with heart failure was 56.1％ （32/57）.The rate was significant higher than 4.4％ （5/113） （P ＜ 0.01）,while the BNP level was lower than 210pg/ml.Conclusion The higher of BNP level,the more serious of heart failure.BNP can be an important reference target to determine the degree of heart failure and prognosis.