稳定扩张性心肌病患者中血浆B型利钠肽和肾素浓度的相互关系

目的 研究B型利纳肽(B-type natriuretic peptide,BNP)生物学变异是否体现稳定慢性心力衰竭(chronic heart failure,CHF)患者疾病进程.方法 比较存在扩张性心肌病(dilated cardiomyopathy,DCM)的稳定CHF患者中BNP和肾素-血管紧张素醛固酮系统(renin-angiotensin-aldosterone system,RAS)因子生物学变量.存在DCM稳定CHF患者80例,测定BNP和RAS因子.结果 经梯式多变量分析,血清BNP在基线水平(P=0.005)、存在房颤(P=0.014)、高血浆肾素浓度(plasma renin concentration,PRC)(PRC,P=0.002)是显著性独立,优势因子,与高BNP相关.随访2个月,无体重和血压的改变,血细胞比容变化(％)与BNP变化不相关(r=-0.325,P=0.000 7),却与PRC变化相关(r=0.680,P=0.001).结论 BNP生物学变异与PRC生物学变异显著相关,提示在脑利钠肽系统与RAS系统存在生理学相互作用,导致在DCM患者中发生BNP的生物学变异.

Relationship between BNP level and PRC of patients with stable dilated cardiomyopathy

Objective To interpret B-type natriurenic peptide(BNP)level in patients with stable chronic heart failure(CHF) and to learn whether the change in BNP represents disease progression.Methods To compare change in BNP and biological variation in factors of the renin angiotensin aldosterone system(RAS) in stable CHF patients with dilated cardiomyopathy(DCM),the level of BNP and RAS factors were measured in 80 stable DCM patients.Results According to stepwise multivariate analysis,serum BNP at baseline(P=0.005),presence of atrial fibrillation(P=0.014),a high biological variation in plasma renin concentration(PRC,P=0.002) were significant independent dominant factors related to a high biological variation in BNP.Although there was no change in body weight or blood pressure during the 2 months following up study period,the change in hematocrit(%) was negatively correlated with the change in BNP(%)(r=-0.325,P=0.000 7) and positively correlated with the change in PRC(r=0.680,P=0.001).Conclusions There is significant relationship between biological variation in BNP and biologicao variation in PRC,suggesting that the physiological interaction between natriuretic peptide system and RAS may contribute to the biological variation in BNP in stable DCM patients.