舒张性心功能不全患者血浆BNP水平的临床研究

目的 探讨舒张性心功能不全患者的血浆脑钠肽（BNP）水平.方法 选择住院70例舒张性心功能不全患者（根据NYHA分级法诊断心功能,将患者分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级;根据超声测定结果将左心室舒张功能障碍分为轻度、中度、重度3组）,40例本院体检中心体检对照者的血浆BNP的水平,比较各组血浆BNP水平的变化情况.结果 舒张性心功能不全患者血浆BNP明显高于健康对照者（P＜0.01）,并且BNP水平随着舒张功能不全分级（Ⅰ～Ⅳ级）升高而梯次升高（P＜0.05）,随着左心室舒张功能障碍（轻-重度）加重而梯次升高（P＜0.05）.结论 血浆BNP可以用于诊断舒张性心功能不全,而且可以反映左室舒张功能障碍的严重程度,可以将BNP作为舒张性心功能不全患者诊断及随访指标.

Clinical study on the level of plasma BNP in patients with diastolic dysfunction

Objective To study the change of plasma brain natriuretic peptide （BNP） in patients with diastolic dysfunction. Methods 70 patients with diastolic dysfunction were selected in this study. According to NYHA, the patients were divided into four groups （ I、 II、 III、 IV ） ; According to echocardiography, the patients were divided into three groups（ mild impairment group, moderate impairment group and severe impairment group）. The level of plasma BNP were measured in patient groups and compared with those of 40 healthy subjects（ control group） in physical examination center in our hospital. Results Compared with the control group, the level of plasma BNP were significantly elevated in patients with diastolic dysfunction （P 〈 0.01 ）. BNP level were gradually increasing from class I group to class IVgroup according to NYHA （P 〈 0. 05 ）. BNP level in severe impairment group were significantly higher than those in mild and moderate impairment groups （P 〈 0. 05 ）. Conclusion The level of plasma BNP can be regarded as one of diagnostic criteria of diastolic dysfunction, and the level of the BNP had significance in diagnosis of different degrees of left ventricular diastolic dysfunction, BNP can become the diagnostic and follow-up indicator in patients with diastolic dysfunction.