心力衰竭患者血清脑钠素测定及其意义

Study on the Clinical Significance of Determination of Serum Brain Natriuretic Peptide (BNP) Levels in Patients with Heart Failure

目的 :探讨心力衰竭 (HF)患者血清脑钠素改变及其意义。方法 :放射免疫分析测定 88例HF(NYHAⅡ -Ⅳ级 )患者、2 0例心功能代偿期对照组 (NYHAⅠ级 )和 30例健康对照组的血清脑钠素水平 ,并进行对照分析。结果 :HF组总体血清脑钠素水平显著高于心功能处代偿期 (NYHAⅠ级 )组 (t=2 1 33,p <0 0 5 )和对照组 (t=2 335 ,p<0 0 5 ) ,NYHAⅡ级心功能时血BNP即显著高于对照组 (p <0 0 5 ) ,Ⅱ、Ⅲ、Ⅳ级组间血清BNP依次递增 (F =2 5 95 ,p<0 0 5 )。急性左心衰组血清BNP显著高于慢性心衰组 (t =2 2 6 8,p <0 0 5 ) ,而且缓解时血清BNP即显著下降 (p <0 0 5 )。结论 :测定血清脑钠素水平有助于HF患者发病机理、病情严重程度和预后的判断。

Objective To study the clinical significance of the changes of serum BNP levels in patients with heart failure (HF). Methods Serum BNP levels in 88 patients with HF(NYHAⅡ-Ⅳ), 20 patients with compensated cardiac function (NYHA Ⅰ) and 30 controls were determined with RIA. Results The serum BNP levels in patients with HF (264±63 9pmol/L) were significantly higher than those in patietns with compensated cardiac function (NYHA Ⅰ, 11 6±4 7pmol/L, t=2 133,p <0 05) and controls (7 6±4 1pmol/L, t=2 335,p <0 05). were no significant differences between the levels in NYHA Ⅰ subjects and controls ( t=0 883,p >0 05). As the cardiac function deteriorated from NYHAⅡ to NYHAⅣ, the BNP levels increased consecutively with significant differences from each other ( F=2 595,p <0 05). BNP levels in patients with acute left heart failure were significantly higher than those in patients with chronic heart failure ( t=2 268,p <0 05) and fell promptly at relief of the attacek ( p <0 05). Conclusion Determination of serum BNP levels in patietns with HF was helpful to the study of the severity and prognosis of the disease.