充血性心力衰竭患者血浆脑钠素浓度与心功能的关系

目的 探讨充血性心力衰竭(CHF)患者血浆脑钠素(BNP)浓度变化及与心功能级别和30天再住院率的关系。方法 随机选择78例CHF患者进行心功能分级(NYHA分级),并测定其入院及出院当天血浆BNP浓度,选择20例健康中老年健康体检者作为对照组。结果 CHF组较对照组血浆BNP浓度明显升高,476.9±243.6pmol/L对184.3±54.2pmol/L(P<0.01);不同心功能分级之间均有显著差异,NYHAⅡ～Ⅳ级血浆BNP浓度分别为263.4±56.3pmol/L、412.1±163.6pmol/L、769.7±141.7pmol/L(各组间P<0.01);33例CHF患者出院时血浆BNP浓度小于300pmol/L,30天再住院率6％,45例CHP患者出院时血浆BNP浓度大于300pmol/L,30天再住院率27％(P<0.05)。结论 血浆BNP浓度可作为诊断CHF的参考指标,随着心衰的加重,血浆BNP浓度逐渐升高,当血浆BNP浓度降至300pmol/L以下时,患者30天再住院率明显下降。

Relationship between Plasma Concentration of Brain Natriuretic Peptide and Cardiac Function in Patients with Congestive Heart Failure

Objective To discuss the relationship among the change of plasma brain natriuretic peptide (BNP) concentration, cardiac function grade and the rate of 30 days re-admission in patients with congestive heart failure(CHF). Method 78 cases of OHF were selected randomly and their cardiac function was graded. Plasma BNP concentration was measured immediately after admission and before discharge. 20 normal people served as control group. Results Plasma BNP concentration in CHF group was significantly higher than that in control group(476.9±243. 6pmol/L vs 184.3±54. 2pmol/L, P< 0.01). There were significant differences in plasma BNP concentration among patients with different cardiac function grade(263.4± 56.3pmol/L, 412.1±163.6pmol/L and 769.7±141. 7pmol/L in NYHA grade Ⅱ~ Ⅳ respectively, P< 0.01). The plasma BNP concentration in 33 cases of CHF was below 300pmol/L, and it was over 300pmol/ L in 45 cases of CHF as discharging. Their 30 days re-admission rate was 6% and 27% respectively( P<0. 05). Conclusions The plasma BNP concentration may be a diagnostic index for CHF. It increases along with the aggravation of CHF. The rate of 30-days re-admission decreases significantly when plasma BNP concentration is below 300pmol/L.