慢性心力衰竭治疗中血浆脑钠肽的变化及其意义

目的：探讨慢性心力衰竭患者治疗中血浆脑钠肽水平的变化及其临床意义。方法：选择慢性心力衰竭患者63例，联合使用β受体阻滞剂及血管紧张素转换酶抑制剂治疗6月，于治疗前后分别测定血浆脑钠肽水平，并使用超声心动图仪检测左心室收缩功能及左心室结构。30名健康者为对照。结果：心力衰竭组血浆脑钠肽水平显著高于对照组（P〈0．001），并与心力衰竭严重程度有关；左心室射血分数显著低于对照组（P〈0．01）。心力衰竭患者血浆脑钠肽水平与心脏结构功能指标的直线相关分析表明，血浆脑钠肽水平与左心室射血分数呈负相关（r=-0．38，P〈0．05），心力衰竭患者有效治疗后，血浆脑钠肽水平显著下降（P〈0．05），左心室射血分数提高（P〈0．05）。结论：血浆脑钠肽水平可作为评价慢性心力衰竭治疗效果的客观指标。

Changes of levels of plasma brain natriuretic peptides in treatment of patients with chronic heart failure

Objective:To evaluate the changes of levels of plasma brain natriuretic peptides(BNP) in patients with chronic heart failure(CHF) before and after treatment. Methods:The contents of plasma BNP were measured in 63 CHF patients. Doppler echocardiography was performed to measure left ventricular function and structure. These patients were treated for six months,the levels of plasma BNP measured again after treatment.The 30 normal persons were enrolled for control. Results:Levels of plasma BNP significantly elevated in CHF patients(P<0.001),and increased levels were proportionte to the severity of left ventricular dysfunction.Level of plasma BNP negatively correlated with left ventricular ejection fraction(r=-0.38,P<0.05) in CHF patients. After treatment,levels of plasma BNP decreased significantly(P<0.05). Conclusion:Plasma BNP level is a marker to reflect left ventricular function.Plasma BNP level is useful index for monitor the change of left ventricular function and to evaluate the effect of treatment.