血浆利钠肽水平与心功能状态的关系

CORRELATION BETWEEN PLASMA LEVELS OF NATRIURETIC PEPTIDES AND THE LEFT VENTRICULAR FUNCTION

目的 :研究慢性心力衰竭患者血浆利钠肽 (ANP ,BNP ,CNP)水平的变化及其与心功能状态的关系。方法 :4 8例慢性心力衰竭患者用免疫放射分析法测定血浆BNP浓度 ,用放射免疫分析法测定血浆ANP ,CNP浓度 ,用心脏彩色多普勒超声诊断仪测定左室结构和功能。结果 :心衰组血浆ANP ,BNP浓度分别为 6 2 2 .4 7±4 35 .5 3pg/ml和 6 5 2 .5 9± 5 4 4 .98pg/ml,较对照组显著增高 (P <0 .0 1) ,与心功能衰竭严重程度有关。血浆BNP水平与左室射血分数呈负相关 (r =- 0 .37,P <0 .0 1) ,与LVEDD、LVMI呈正相关 (r均为 0 .36 ,P <0 .0 5 )。心衰组血浆CNP水平与对照组比较差异无统计学意义 (P >0 .0 5 )。结论 :血浆ANP ,BNP水平可作为反映心功能状态的指标 ,BNP水平更敏感 ,并与心脏结构有关。

Objective:To investigate the correlation between plasma levels of natriuretic peptides and the left ventricular function and structure in patients with chronic heart failure (CHF).Methods:48 patients with CHF,according to the New York Heart Association (NYHA) class,were measured by radioimmunoassay and immunoradiometric assay in these patients and 10 thealthy controls.Doppler echocardiography was performed to measure parameters of left ventricular function and structure as well.Results:Plasma levels of ANP and BNP were significantly elevated in CHF patients ( P all <0.01),and levels increased in proportion to the severity of left ventricular dysfunction.Plasma level of BNP had a negative correlation with LVEF ( P <0.05),and a positive correlation with left ventricular end-diameter and left ventricular mass index ( P <0.05 or 0.01).After three-month optimized treatment,ANP and BNP plasma levels both decreased in patients.Conclusions:ANP and BNP plasma levels were good markers used to reflect left ventricular function,whereas BNP level was more sensitive and sepcific and had a close relationship with left ventricular structure.