血清钙离子浓度对脑钠肽评价心功能的影响

目的:探讨血清Ca2+对脑钠肽(BNP)评价心功能的影响及其机制。方法:选择急性左心功能不全患者101例,根据心功能NYHA分级及所有患者血BNP浓度中位数(793 pg/mL),将患者分为A组:心功能NYHAⅠ、Ⅱ且BNP793 pg/mL,23例;B组:心功能NYHAⅢ、Ⅳ且BNP793 pg/mL,24例。比较2组患者的左室射血分数(LVEF)、左室短轴EF值(LVFS)、左室舒张末内径(LVEDD)、室间隔缺损(IVSD)、左房内径(LA)和血BNP、钾、钠、氯、血清Ca2+、葡萄糖、尿素氮、血肌酐、血红蛋白、肌酸激酶、肌酸激酶同功酶MB、尿酸、TNT、高敏CRP。结果:全部患者LVEF(50.0±10.2)%和BNP(1037.6±1136.2)pg/mL之间存在显著负相关(r=-0.258,P0.05),A组血清Ca2+浓度明显低于B组[(1.86±0.08)mmol/L vs(2.05±0.03)mmol/L,P0.05]。结论:血清Ca2+浓度是影响BNP评价心功能的重要因素。

The influence of serum calcium ion concentration on B-type natriuretic peptide in evaluating heart function

Objective： To explore the influence of serum calcium ion concentration on B-type natriuretic peptide （BNP） in evaluating heart function and its mechanism. Methods： One hundred and one patients with acute left cardiac insufficiency were involved in the study. According to NYHA heart functional grade and the median of BNP in all patients （793 pg/mL）, patients were divided into group A （23 cases） with NYHA Ⅰ and Ⅱ , BNP 〉793 pg/mL; group B （24 cases） with NYHA m and IV, BNP 〈 793 pg/mL. Left ventricular ejection fraction （ LVEF）, left ventricalar fraction shortening （ LVFS）, left ventricular end diastolic diameter （LVEDD）, inlet ventricular septal defect （IVSD）, left atrium （LA）, and serum concentrations of BNP, K ^＋ , Na ＋ , Cl^＋, serum calcium ion concentration, glucose, urea nitrogen, creatinine, hemoglobin, ereatine kinase, ereatine kinase isoenzyme, uric acid, TNT, and hsCRP were compared between two groups. Results ： LVEF （50.0 ± 10.2 ） % is negatively correlated with BNP （ 1037.6 ±1136.2） pg/mL （ r = 4）. 258, P 〈 0.05 ）. Serum calcium ion concentration was lower in group A than that in group B [ （ 1.86 ±0. 08 ） mmol/L vs （2.05 ± 0.03 ） mmol/L, P 〈 0.05 ]. Conclusions： Serum calcium ion concentration may play an important role to evaluating heart function by BNP.