脑钠素在心力衰竭患者中的临床应用价值

目的探讨脑钠素（brainnatriuretic peptide，BNP）在心力衰竭（chronic heart failure，CHF）患者中的临床应用价值。方法使用微粒子免疫定量检测法．检测76例CHF患者及20例健康体检者血浆BNP水平，并于治疗后2周检测61例Ⅱ～Ⅳ级CHF患者血浆BNP水平。结果CHF各组BNP水平明显高于正常对照组，而CHF各组LVEF水平明显低于正常对照组，差异有统计学意义（P〈0．05）。随着病情的进展，血浆BNP含量逐渐增高（P〈0．05），LVEF逐渐降低（P〈0．05）。直线相关分析显示，血浆BNP水平与LVEF呈显著负相关性（r=-0．397，P〈0．05）。治疗后2周BNP水平明显下降，而LVEF水平明显升高，与治疗前比较差异有统计学意义（P〈0．05）。结论BNP既可作为较可靠的CHF早期预测参考指标，也可作为判断CHF严重程度和疗效以及预测预后的指标。

The Clinical Application Value of Brain Natriuretic Peptide in Chronic Heart Failure Patients

OBJECTIVE To discuss the clinical value of brain natriuretic peptide（BNP）in chronic heart failure（CHF）patients. METHOD Serum BNP levels in 76 CHF patients and 20 healthy controls were detected by microparticle immuno-quantitation method. Furthermore serum BNP of 61 Ⅱ-Ⅳ CHF patients were retested after two weeks of anti-HF treatment. RESULTS The levels of BNP in all groups of CHF were significantly higher than those in healthy controls（P〈0.05） while LVEF in all groups of CHF were significantly lower than those in healthy controls （P〈0.05）. With aggravation of CHF, the levels of BNP were gradually increased （P〈0.05） and LVEF were gradually decreased （P〈0.05）. Serum BNP was significantly correlated with LVEF（r=-0.397 ,P〈0.05 ）. After treatment for 2 weeks, the levels of BNP were decreased（P〈0.05） and LVEF were increased（P〈0.05） compared with pretreatment. CONCLUSION BNP not only can be an early diagnosis index, but also can identify CHF sverity and efficacy and predict its outcome.