血浆利钠肽水平与慢性心力衰竭的探讨  

Relationship between the level of natriuretic peptide and chronic heart failure

作　　者：蒲艳[1] 

机构地区：[1]贵州省人民医院,贵阳550002

出　　处：《贵州医药》2004年第10期879-881,共3页Guizhou Medical Journal

摘　　要：目的探讨心力衰竭患者血浆利钠肽水平及其与心功能的关系。方法采用放免法检测 5 4例心力衰竭患者 (CHF组 :其中NYHAⅡ级 12例 ,Ⅲ级 2 4例 ,Ⅳ级 18例 )及 2 0例健康者 (对照组 )血浆ANP、BNP和CNP的浓度 ,同时用多谱勒超声心动图测定左室射血分数 (LVEF)。结果与对照组比较 ,心力衰竭患者血浆ANP、BNP浓度显著升高 (P <0 0 1) ,CNP浓度无明显变化 (P >0 0 5 ) ;慢性心力衰竭患者血浆ANP、BNP浓度随心功能的恶化逐渐升高 (均P <0 0 1) ,血浆CNP浓度在NYHAⅡ级患者显著升高 (P <0 0 1) ,而NYHAⅢ～Ⅳ级患者血浆CNP浓度无明显改变 (P >0 0 5 ) ;血浆ANP、BNP浓度与LVEF之间呈明显的负相关 ,BNP的相关性更为显著 (P <0 0 5 ,P <0 0 1) ,CNP浓度与LVEF之间无明显相关性 (P >0 0 5 )。结论血浆利钠肽与心力衰竭的发生发展有关 ;BNP可评价慢性心力衰竭的严重程度。Objective To investigate the relationship between the level of natriuretic peptide and NYHA functional class of the patients with chronic heart failure. Methods The levels of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP) and left ventricular fraction (LVEF) of 54 patients with chronic heart failure (CHF group: NYHAII=12, NYHAIII=24, NYHAIV=18) and 20 as normal control group were measured by radioimmunoassay and Doppler echocardiography respectively.Results 1. The levels of ANP and BNP of the CHF group were higher than those of the control group (P<0.01), the level of CNP of the CHF group was not significant with control group (P>0.05). 2. The levels ANP and BNP were gradually increased with deteriorated of NYHA functional. The level of CNP of NYHAII in the CHF group was higher than control group (P<0.01), but the level of CNP of NYHAIII-IV were not significant than control group (P>0.05). 3. There significantly inverse correlations between ANP, BNP and LVEF respectively (P<0.01), but no correlations between CNP and LVEF (P>05). Conclusion The findings suggested that ANP, BNP and CNP could play important roles in the pathophysiologic changes of CHF. BNP could be used to evaluate the degree of chronic heart failure.

关 键 词：血浆 BNP CNP 利钠肽 ANP 慢性心力衰竭 LVEF 水平 负相关 

分 类 号：R541[医药卫生—心血管疾病] R743[医药卫生—内科学]