慢性心力衰竭患者血浆脑钠肽水平研究

目的：研究慢性心力衰竭患者血浆脑钠肽水平与左室功能的关系，探讨血浆脑钠肽在慢性心力衰竭的诊断、病情评估中的临床应用价值。方法：对134例慢性心力衰竭患者（CHF组，NYHA心功能Ⅱ～Ⅳ级）及102例健康体检者（正常对照组），采用ELISA法测定血浆脑钠肽水平，应用心脏彩色多普勒超声诊断仪测定左室射血分数、心脏指数，并将CHF组的血浆脑钠肽水平与左室射血分数、心脏指数作相关性分析。结果：CHF组血浆脑钠肽水平显著高于正常对照组（P〈0．01）。CHF组血浆脑钠肽水平随NYHA心功能分级程度的升高而显著增加（P〈0．01），其与左室射血分数、心脏指数呈负相关（P〈0．05）。CHF组患者经正规治疗后，随着心功能改善，血浆脑钠肽水平明显降低（P〈0．05）；NYHA心功能无改善的患者出院时血浆脑钠肽水平明显高于心功能至少改善一级的患者（P〈0．01）。结论：血浆脑钠肽水平能较好地反映慢性心力衰竭患者左室功能状态，其对于慢性心力衰竭的诊断、病情评估具有临床应用价值。

Study on the relationship between plasma level of brain natriuretic peptide and the cardiac function in the patients with chronic heart failure

Objective To study the relationship between level of brain natriuretic peptide and the cardiac function in the patients with chronic heart failure and to investigate the value of brain natriuretic peptide in the diagnosis and illness evaluation on chronic heart failure.Methods The plasma brain natriuretic peptide level of 134 chronic heart failure patients and 102 controls were measured with ELISA method.Left ventricular ejection fraction and cardiac index were detected with color Doppler.Correlation analysis was done between plasma level of brain natriuretic peptide and left ventricular ejection fraction,cardiac index in chronic heart failure patients.Results The plasma brain natriuretic peptide level in chronic heart failure group was much higher than that in the controls(P<0.01),which was positively correlated with NYHA class,and negatively with left ventricular ejection fraction and cardiac index.After regular treatment,with the improving of heart function,the level of brain natriuretic peptide declined obviously(P<0.05).Brain natriuretic peptide level in the patients without improved heart function was significantly higher than that in the patients with improved heart function(P<0.01).Conclusion The plasma level of brain natriuretic peptide is correlated with the cardiac function in patients with chronic heart failure,and it has some clinical value in the diagnosis and evaluation of the condition on the patients with chronic heart failure.