利钠肽检测评价慢性充血性心力衰竭治疗反应

目的　评价在 β受体阻滞剂治疗慢性充血性心力衰竭 (CHF)中脑利钠肽 (BNP)检测意义。方法　选择CHF、心功能Ⅱ～Ⅲ级 (NYHA)患者 33例 ,年龄 19～ 76岁 ,平均 (5 7 5± 15 8)岁。检测房利钠肽 (ANP)、BNP后 ,将其分基础治疗组 12例 (血管紧张素转换酶抑制剂、利尿剂、地高辛 ) ,美托洛尔组 10例 (基础治疗 +美托洛尔 ) ,卡维地洛组 11例 (基础治疗 +卡维地洛 ) ,接受抗心力衰竭 (心衰 )治疗 ,并在治疗 3个月后重复检测ANP、BNP。ANP用放免法 (RIA)测定 ,BNP采用固相免疫放射测定法 (IRMA)测定。结果　心衰有效治疗后ANP、BNP均有显著下降 ,其中 β受体阻滞剂治疗组BNP下降最显著。结论　在评价心衰接受 β受体阻滞剂的治疗反应中BNP具有重要的应用价值。

The changes of plasma levels of brain natriuretic peptides in evaluation of treatment responses in chronic heart failure

OBJECTIVE: To evaluate the changes of plasma levels of brain natriuretic peptides in patient with chronic heart failure (CHF) and the effect of beta-blockers (BB) on CHF. METHODS: We enrolled 33 patients with CHF, NYHAII-III, age 19 - 76 (57.5 +/- 15.8) years. Plasma levels of atrial and brain natriuretic peptides (ANP, BNP) were measured with radioimmunoassay and immunoradiometric assay in these patients. All the patients were assigned to 3 groups as follows: standard therapy group 12 cases (receiving ACEI + digoxin + diuretic), metoprolol treatment group 10 cases (receiving metoprolol in addition to the standard therapy), carvedilol treatment group 11 cases (receiving carvedilol in additional to the standard therapy). These patients were treated for three months, the therapeutic effects were assessed by change of plasma levels of ANP and BNP. RESULTS: Plasma levels of ANP and BNP were significantly elevated in CHF patients. After treatment, ANP and BNP plasma levels both decreased significantly. In patients receiving beta-blockers, BNP plasma levels decreased most significantly. CONCLUSION: BNP plasma level is a good marker to reflect left ventricular function. Measurement of BNP plasma level is useful to monitor the change of left ventricular function and to evaluate the effect of treatment with beta-blockers.