B型利钠肽对慢性心力衰竭的诊断价值及与左心功能的关系  

The Diagnostic Value of B-Type Natriuretic Peptide on Congestive Heart Failure and the Relationship Between BNP and Ventricular Dysfunction

作　　者：赵茹[1] 张连祥[1] 张静霞[1] 孙根义[1] 刘玉洁[1] 高明东[1] 陈刚[1] 萧健勇[1] 张颖[1] 杨丽[1] 

机构地区：[1]天津市胸科医院心内科,300051

出　　处：《中国循环杂志》2004年第4期294-296,共3页Chinese Circulation Journal

摘　　要：目的 :探讨血浆B型利钠肽 (BNP)水平在慢性心力衰竭 (CHF)中的诊断价值 ,以及血浆BNP与CHF严重程度和左心室功能的关系。方法 :对 96例根据病史、体征、心脏X线胸片、实验室检查及对治疗反应等临床诊断为CHF的患者 ,就诊后 2 4h内取静脉血测定血浆BNP ,并行超声心动图检查 ,分析血浆BNP与NYHA心功能分级及左心室射血分数之间的关系。结果 :按照心功能分级 ,Ⅰ～Ⅳ级患者血浆BNP逐步增加 (P <0 0 0 1) ;左心室舒张末期内径≤ 5 5mm的血浆BNP显著低于内径 >5 5mm者 (P <0 0 1) ;且左心室射血分数≤ 0 5 0的血浆BNP显著大于射血分数 >0 5 0者 (P <0 0 0 1)。结论 :血浆BNP水平提示能客观的反映心功能的情况 ,可作为一种简便快速的手段用于CHF的诊断及危险分层。Objective: Plasma B-type natriuretic peptide(BNP) was conducted to asses the clinical value in the diagnosis of congestive heart failure and the relationship between BNP and ventricular dysfunction.Methods: Ninety-six patients with congestive heart failure were obtained from their clinical history,symptoms and signs,X-ray,lab examination and echocardiography. BNP was measured in a blinded fashion. Results: The mean BNP concentration in blood samples obtained from patients with congestive heart failure was high gradually with the degree of NYHA from Ⅰ to Ⅳ,They were(142.6±79.6)pg/ml ( n =25),(329.6±180.0) pg/ml( n =20),(618.2±411.5)pg/ml( n =24),(1247.1±1187.2)pg/ml( n =27, F =13.36, p =0.000),respectively. The BNP levels in patients with low left ventricular ejection fraction(≤0.50) were higher than in that with high LVEF (>0.50)(1244.1±1024.4) pg/ml ( n =54) vs (134.4±167.4) pg/ml ( n =42, p =0.000). The BNP level in patients with high left ventricular end-diastolic diameter(LVEDD) (>55 mm) was higher than in that with low LVEDD (≤55 mm)(943.7±1106.3) pg/ml ( n =50) vs (344.7±581.0) pg/ml( n =46, p =0.008).Conclusion: Plasma BNP may be a useful screening test in higher risk individuals in whom there are no other clinical indications for echocardiography. The BNP concentrations are related to the LVEF,or ventricular function.

关 键 词：BNP 血浆 CHF B型利钠肽 慢性心力衰竭 诊断价值 左心室射血分数 水平 结论 情况 

分 类 号：R541[医药卫生—心血管疾病] R542[医药卫生—内科学]