98例慢性心力衰竭患者血浆BNP和血脂变化及意义

目的：探讨98例慢性心力衰竭（CHF）患者的血浆脑钠素（BNP）和血脂分析早期诊断和治疗的临床意义。方法：化学发光免疫分析测定了98例CHF患者（其中Ⅱ级心功能38例,Ⅲ级心功能30例,Ⅳ心功能30例）血浆中的BNP水平。48例CHF（其中Ⅲ级心功能24例,Ⅳ级心功能24例）测定了抗CHF药物综合治疗后的血浆BNP水平并与治疗前进行了对比性分析。生化法测定了98例CHF患者的血脂水平,包括总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）并与60例正常对照组进行了比较性分析。结果：98例CHF患者血浆BNP水平较之60例正常对照组明显增高（P〈0.01）,并随CHF心功能的恶化,血浆BNP水平呈上升趋势,而LVEF呈下降趋势;抗CHF药物综合治疗后,血浆BNP水平明显降低（P〈0.05）。血脂分析表明,98例CHF患者较之60例正常对照组,血清TC、TG和HDL-C水平明显降低（P〈0.05～0.01）,而LDL-C水平明显增高（P〈0.05～0.01）,CHF患者Ⅱ～Ⅳ级心功能之间血脂无明显差异（P〉0.05）。结论：CHF中血浆BNP水平和血脂分析不仅是CHF急诊早期诊断的有效指标,而且血浆BNP水平的动态观察是CHF疗效考核的良好佐证。

Clinical Significance of Changes of Plasma BNP and Blood Lipid in Patients with CHF

Objective To study the early diagnostic value of determination of changes of plasma BNP and blood lipid profile in patients with CHF.Methods Plasma BNP（with CLIA）and blood lipid profile（with biochemistry）were determined in 98 patients with CHF（38 Ⅱ grade,30 Ⅲgrade and 30 Ⅳ grade）and 60 controls.Results Plasma BNP levels in patients with CHF were significantly higher than those 60 controls（P0.01）and increased with severity along with decreasing LVEF.After a course of treatment,the plasma BNP levels in 48 treated patients（including 24 Ⅲ grade and 24 Ⅳ grade）were significantly lower than those before therapy（P0.05）.With blood profile,TC,TG and HDL-C levels in patients with CHF were significantly lower than those in controls（P0.05~0.01）,but LDL-C levels were significantly higher than those in controls（P0.05~0.01）.Conclusion Plasma BNP determination and blood lipid analysis were very useful for early diagnosis of CHF in emergency.Dynamic observation of changes of BNP might be useful in assessment of severity and prognosis of patients with CHF.