慢性充血性心力衰竭血浆脑钠肽的变化及其对预后的影响

目的探讨慢性充血性心力衰竭（CHF）患者血浆脑钠肽（BNP）水平的变化及其临床意义。方法选择CHF患者66例,于治疗前后分别测定血浆BNP水平并与30名健康者为对照。结果 CHD组患者的血浆BNP、LVEDD、LVESD和心胸比值较对照组明显增加,LVEF较对照组明显减低,差异均有统计学意义（P〈0.01）;CHF患者血浆BNP水平随着NYHA心功能的加重而上升,差异有统计学意义（P〈0.05或0.01）;BNP与LVEF呈负相关（γ=-0.652,P〈0.01）,BNP与LVEDD、LVESD和心胸比值呈正相关（γ=0.578,0.592,0.613,P〈0.01）;发生事件组（22例）血浆BNP（222.43±13.43）ng/L,明显高于未发生事件组（44例）血浆BNP（133.49±25.28）ng/L,两组间有显著统计学差异（P〈0.01）;44例未发生事件组CHF患者治疗后血浆BNP水平明显降低,LVEF增高,心胸比值降低（P〈0.05）。结论血浆BNP水平和心脏结构相关,可作为反映心功能状态的指标,可作为CHF诊断、病情和预后判定的重要指标。

Change of plasma brain natriuretic peptide in patients with chronic congestive heart failure and its effect for post-cure

Objective Study change of plasma brain natriuretic peptide（ BNP） in patients with chronic congestive heart failure（ CHF） and its clinical significance. Methods 66 cases of CHF patients were selected,and assayed plasma BNP level before and after treatment,30 cases of health were as control. Results Plasma BNP,LVEDD,LVESD and cardiothoracic ratio in CHD group were obviously increased and LVEF obviously decreased comparing with control group. The differences were statistically significant（ P〈 0. 01）. Plasma BNP level in CHF patients went up with the aggravation of NYHA cardiac function,The differences were statistically significant（ P〈 0. 05 or 0. 01）. BNP was negatively correlated with LVEF（ γ = -0. 652,P〈 0. 01）. BNP was positively correlated with LVEDD,LVESD and cardiothoracic ratio（ γ = 0. 578,0. 592,0. 613,P〈 0. 01）. Plasma BNP（ 222. 43 ± 13. 43 ng/L） in events group（ 22 cases） significantly higher than the plasma BNP（ 133. 49 ± 25. 28 ng/L） in no event group（ 44 cases）. The differences were statistically significant（ P〈 0. 01）. In 44 cases of no event group,plasma BNP level and cardiothoracic ratio were obviously decreased and LVEF was increased after treatment（ P 〈0. 05）. Conclusion Plasma BNP level is related with cardiac structure. It can be used as indicators to reflect the state of cardiac function,the diagnosis of CHF and important indicators for the assessment of patient＇s condition and post-cure.