生物标志物-血清脑钠素在充血性心力衰竭诊断中的价值

目的 探讨血清脑钠素(BNP)水平在评价充血性心力衰竭(CHF)中的应用价值,以及观察不同病因的心衰患者血清BNP的水平变化.方法 选取100例CHF患者,并根据纽约心脏协会(NYHA)分级标准分为Ⅱ-Ⅳ级,选取100名心功能正常者为实验对照,采用全自动免疫分析仪(罗氏2010型)电化学发光法(E-CLA)测定各组HF患者血清BNP水平.结果 CHF病人血清BNP为4 745.49±3 698.70 ng/ml,高于对照组66.18±44.30 ng/ml,两者相比差异具有统计学意义(P<0.05),且BNP浓度随着心功能分级的增加也增加;不同病因(高血压、冠心病、风心病)所致的CHF患者血清BNP水平(NYHAⅢ、Ⅳ级)的差异无统计学学意义(P>0.05),但NYHAⅡ级各病因组间BNP水平差异有显著性(P<0.05).结论 CHF患者血清BNP水平显著增高,且随着NYHA分级增加而增加,可作为评价CHF严重程度的客观指标.

Measurement of Serum Brain Natriuretic Peptide Level as a Biomarker for Congestive Heart Failure

Objective To explore the value of Brain Natriuretic pepfide (BNP) in estimating the degree of seriousness of congestive heart failure (HF) and study BNP level of CHF caused by various cardiovascular diseases.Methods 100 patients with CHF were divided into three classes (classⅠ,Ⅱ and Ⅳ)by New York Heart Association (NYHA) functional classification Standard. 100 healthy individuals were selected into control group.Serum BNP concentration Were measured by electrochemical luminescence assay (Elecsys 2010,Roche Diagnostics).Results Mean serum BNP concentration of patients with CHF was 4 745.49±3 698.70 ng/ml,which was higher significantly than that of normal control (66.18±44.30ng/ml).Moreover,the growth in BNP level was increased with NYHA functional classification:class Ⅳ (1 0251±9 326.8 ng/ml) >class Ⅲ(1 239±1 063.8 ng/ml) > class Ⅱ (167.4±143.4 ng/ml),which was statistically significant (P<0.05).It was statistically significant among three groups of pathogenesis (hypertension,coronary heart disease and rheumatic heart disease) of CHF in the NYHA classification level Ⅱ,whereas there was no difference between class Ⅲ and class Ⅳ.Conclusion Serum BNP level can be applied as a biomarker for congestive heart failure and can estimate the severity of CHF.