左心衰竭患者B型利钠肽与心功能指标的相关性分析

目的:评价左心衰竭患者的B型利钠肽(BNP)与临床NYHA心功能分级和超声心动图所测指标的相关性。方法:使用荧光免疫的方法测定243例左心衰竭患者(左心衰竭组)和111例对照组的血BNP值,测值与临床NYHA分级、左心房内径(LAD)、左心室舒张末内径(LVEDD)和左心室射血分数(LVEF)进行相关性分析。结果:与对照组相比,左心衰竭组的LAD和LVEDD均显著增大(P均<0．001),LVEF显著降低(P<0．001),血BNP显著升高达16倍(P<0．001),且随NYHA心功能分级程度的加重,而呈逐级显著升高(P均<0．001)。对照组LogBNP与年龄(r=0．328,P<0．001)和性别(r=0．221,P<0．05)呈正相关。左心衰竭组的LogBNP与NYHA分级(r=0．820,P <0．001)、LAD(r=0．263,P=0．001)和LVEDD(r=0．531,P<0．001)均呈显著正相关;而与LVEF(r=-0．596,P< 0．001)呈显著负相关。多元回归分析显示,LogBNP仅与NYHA分级B(SE):0．435(0．028),P<0．001]和LVEFB (SE):0．007(0．002),P<0．001]独立相关,且与前者的相关性最强。结论:左心衰竭患者BNP水平随NYHA分级增加,呈逐级显著升高,且与NYHA分级和左心室射血分数独立相关。

The Correlation of Brain Natriuretic Peptide With Clinical and Echocardiographic Parameters of Heart Function in Patients With Heart Failure

Objeclive:To evaluate the correlation of plasma B-type nalriurelic peptide(BNP)level with clinical, New York Heart Association (NYHA) functional class and echocardiographic functional parameters. Methods: We measured BNP of whole venous blood with fluorescence immunoassay in 243 left ventricular heart failure patients and 111 normal subjects. The correlation analysis was made between LogBNP and NYHA functional class,left atrium diameter (LAD), left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction(LVEF). Results:The LAD and LVEDD were significantly enlarged whereas LVEF was significantly reduced and the levels of BNP were 16 times higher in the heart failure HF] patients than in the control group(all P<0.001). BNP was gradually and significantly increased with the worsened NYHA functional class(P<0.001). In univariant analysis, LogBNP was positively related to age(r = 0.328, P<0.001) and sex (r=0.221,P<0.05) in control group, and was also significantly related to NYHA functional class(r = 0. 820,P<0.001),LAD(r = 0.263,P =0.001) , LVEDD(r =0.531,P<0.001) and LVEF(r = -0.596,P<0.001)in HF group. In the multiple regression analysis, only NYHA(BSE]:0.435(0.028);P<0.0001) and LVEF(BSE]: 0. 0070.002];P<0.001)were independent correlative makers for LogBNP,the former being stronger than the latter. Conclusion:In heart failure patients, BNP was gradually and significantly increased with the worsened NYHA functional class,and LogBNP was independenty correlated with NYHA classification and LVEF.