脑钠肽与慢性心力衰竭严重程度相关性研究

Correlation study between brain natriuretic peptide and the severity of chronic heart failure

目的探讨血浆N-末端脑钠肽与慢性心力衰竭严重程度的相关性。方法将78例慢性心衰患者设为研究组，其中心功能Ⅱ级24例、Ⅲ级31例、Ⅳ级23例，30名心功能正常者作为对照组。收集两组临床一般资料，比较人院时血浆脑钠肽、左室射血分数、左室舒张末期内径，随访1a统计心血管事件发生率及死亡率。结果研究组血浆脑钠肽水平、左室舒张末期内径显著高于对照组，左室射血分数显著低于对照组（P〈0．01），且心功能Ⅱ级、Ⅲ级、Ⅳ级患者上述指标比较差异有统计学意义（P〈0．01）。研究组脑钠肽水平随心功能分级升高而升高，与心功能分级呈显著正相关（P〈0．01），与左室射血分数呈显著负相关（P〈0．01），与左室舒张末期内径呈显著相关（P〈0．01）。随访1a，不同心功能分级患者心血管事件发生率、死亡率比较差异有统计学意义（P〈0．05）。结论血浆脑钠肽水平与慢性心力衰竭严重程度有显著相关性，可作为慢性心衰的辅助诊断指标与预后评估指标。

Objective To investigate the correlation between plasma Nterminal brain natriuretic peptide （BNP） and the severity of chronic heart failure （CHF）. Methods 78 patients with chronic heart failure were selected as observation group, in which there were 24 cases with heart function grade Ⅱ, 31 cases with grade Ⅲ and 23 cases with grade Ⅳ. 30 cases with normal heart function were selected as control group. The general clinical data of all subjects were collected, and plasma BNP levels, left ventricular ejection fraction （LVEF）, left ventricular end diastolic diameter （LVEDD） at admission were compared, patients were followed up, cardiac events occurrence rate and death rate were recorded. Results The plasma BNP level and LVEDD in observation group was significantly higher than those in the control group, the LVEF of observation group was significantly lower than that of the control group, and there were significant differences in the above indexes between different cardiac function grades （P〈0.01）. The level of BNP in observation group was increased with the rising of cardiac function classification, and was positive related with cardiac function classification （P〈0.01）, and negatively related with LVEF （P〈0.01）, and significantly related with LVEDD （P〈0.01）. Difference of cardiovascular events occurrence, death rate in patients with different cardiac function classification had statistic significance （P〈0.05）. Conelusion The plasma BNP level is significantly correlated with the severity of CHF, and can be used as an assistant diagnostic index and a indicator for evaluating the prognosis.