B型利钠肽对心力衰竭诊断和心功能分级的临床研究

目的研究B型利钠肽(BNP)对心功能的评价及其在诊断慢性充血性心力衰竭中的初步应用。方法测定87例心力衰竭(心衰)病人血液BNP水平、心脏彩超测定左室射血分数(LVEF)等指标,对心功能与BNP水平和LVEF的关系进行观察分析。根据美国纽约心脏病协会(NYHA)分级方案对心衰患者进行心功能分级,心衰诊断以临床医生依据病史、症状、体征、客观检查等作出的综合判断为金标准。再根据LVEF将心衰患者分为3组。结果随着心功能分级的增加,BNP水平上升明显,NYHAⅠ~Ⅳ级患者血BNP水平差异有高度显著性(P<0.01)。随着LVEF降低,BNP升高,3组间差异有高度显著性(P<0.01)。结论BNP可以客观准确评价心功能,可作为临床诊断心衰的实验室指标之一。

Clinical study of B type natriuretic peptide in diagnosis of heart failure and evaluation of cardiac function

Objective To investigate B type natriuretic peptide(BNP) in evaluation of cardiac function and diagnosis of chronic congestive heart failure.Methods The blood BNP level in 87 patients with heart failure was detected and the left ventricular ejection fraction(LVEF) was measured by the modified Simoson's equation with echocardiography.The relationship of cardiac function with BNP level and LVEF was analyzed.The cardiac function was classified by NYHA class.The diagnosis of heart failure by clinical physicians according to case history,signs and symptoms,objective examination was considered to be golden standard.The patients with heart failure were subdivided into 3 groups according to LVEF. Results With the worsened cardiac function class,the BNP level increased significantly.And BNP level differed significantly among patients with NYHA Ⅰ～Ⅳ class,there were statistically significant differences(P<0.01).The decreased LVEF resulted in elevated BNP,there was statistically significant difference(P<0.01) comparing among the 3 groups.Conclusion BNP can objectively evaluate the cardiac function,and it can be used as a marker of clinical diagnosis of heart failure.