心力衰竭患者脑利钠肽检测的临床意义

目的探讨心力衰竭（心衰）患者快速检测血浆脑利钠肽（BNP）水平对心衰诊断的临床意义。方法应用美国Triage诊断仪检测心衰组（106例）和对照组（32例）血浆BNP水平。超声心动图检查左室舒张期末内径（LVEDD）、左室射血分数（LVEF）。结果心力衰竭各组血浆BNP（ng·L^-1）水平明显高于对照组（P〈0．01），且Ⅱ、Ⅲ、Ⅳ级组间血浆BNP水平依次递增（P〈0．01）。血浆BNP与超声指标做直线相关回归分析表明，BNP与LVEDD呈正相关（r=0．68，P〈0．01），与LVEF呈负相关（r=-0．75，P〈0．01）。房颤组血浆BNP水平（929．65±240．60）ng·L^-1，明显高于非房颤组患者（465．98±169．28）ng·L^-1。（P〈0．01）。结论血浆BNP水平对心衰的诊断及严重程度评价有重要价值。

Clinical significance of B-natriuretic peptide in patients with decompensated heart failure

Aim To study the clinical significance of B-natriuretic peptide(BNP)in patients with decompensated heart failure(HF).Methods BNP levels(TRIAGE BIOSITE Diagnostics)were obtained in 106 chronic heart failure patients and 32 control subjects.106 patients were diagnosed to chronic heart dysfunction by Framingham criteria,and were grouped into 3 groups according to New York Heart Association(NYHA)classⅡ,Ⅲ and class Ⅳ.Left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)of all patients were measured by echocardiogram.Results The BNP levels of HF were significantly higher than control subjects.BNP level was gradually increasing from class II group to class Ⅳ group.BNP level in class Ⅳ group was significantly higher than that in classⅡ,Ⅲ group(P<0.01).BNP level in class Ⅲ and class Ⅳ group was higher than that in class II group(P<0.01).The plasma BNP levels was inversely correlated with LVEF(r=-0.75,P<0.01)and has significant positive correlation with LVEDD(r=0.68,P<0.01).The levels of BNP in atrial fibrillation(AF)were significantly higher than those in the non-atrial fibrillation group(929.65±240.60)ng·L-1 vs(465.98±169.28)ng·L-1,P<0.01 ].Conclusion BNP may be a routine method to evaluate heart function and can evaluate prognosis in heart dysfunction.