慢性心力衰竭患者血中脑钠素、心肌肌钙蛋白水平的检测及其临床意义  

Significance of brain natriuretic peptide and cardiac troponin I in patients with heart failure

作　　者：方征[1] 李方[2] 高扬[3] 邹雄[3] 

机构地区：[1]济南铁路中心医院干部保健科,山东济南250001 [2]山东大学齐鲁医院心内科,山东济南250012 [3]山东大学齐鲁医院中心实验室,山东济南250012

出　　处：《山东大学学报（医学版）》2004年第6期702-704,共3页Journal of Shandong University:Health Sciences

摘　　要：目的:探讨缺血性心脏病慢性心力衰竭患者治疗前后血中脑钠素穴BNP雪和心肌肌钙蛋白I穴cTnI雪水平的变化及其临床意义。方法:将42例慢性心力衰竭患者分为Ⅰ组(29例,cTnI<0.15ng/ml雪和Ⅱ组(13例,cTnI>0.15ng/ml),均给予地高辛、利尿剂和血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体拮抗剂等常规治疗,分别于治疗前、治疗后2周和4周检测左室舒张末期内径(LVDd)、左室射血分数(LVEF)、BNP和cTnI等指标。结果:治疗前Ⅱ组LVEF值显著低于Ⅰ组(P<0.05雪,心功能分级、LVDd、BNP、cTnI测值显著高于Ⅰ组(P<0.05雪;治疗2周后,Ⅰ组心功能分级、LVEF值、LVDd及BNP水平明显改善,与治疗前比较差异具有统计学意义(P<0.05雪;治疗4周后,Ⅱ组心功能分级、LVEF值、LVDd、BNP及cTnI水平较治疗前明显改善(P<0.05雪,但Ⅱ组LVDd及cTnI水平仍高于Ⅰ组治疗后水平(P<0.05雪;治疗前,Ⅰ组BNP水平与LVDd测值呈高度正相关(r=0.871),Ⅱ组BNP水平与LVDd测值呈中度正相关(r=0.619),两者比较,差异具有统计学意义(P<0.05);Ⅱ组cTnI水平与LVDd测值呈正相关(r=0.629)。结论:综合评价BNP和cTnI的测定结果,可以了解慢性心力衰竭患者的心功能状况和左室重塑程度,预测心衰患者对治疗的反应,为临床治疗提供指导。Objective: To investigate the alteration and clinical significance of brain natriuretic peptide(BNP) and cardiac troponin I (cTnI) in patients with congestive heart failure and ischemic heart disease before and after treatment. Methods: Fourty-two patients were divided into groupⅠ(29, cTnI<0.15 ng/ml) and groupⅡ(13,cTnI>0.15 ng/ml). Left ventricular end-diastolic dimension(LVDd), left ventricular ejection fraction(LVEF), BNP and cTnI were measured before and 2, 4 weeks after treatment. Results: LVEF was significantly lower and heart function classification (HFC), LVDd, BNP and cTnI were significantly higher in groupⅡ than those in groupⅠbefore treatment. Two weeks after treatment, HFC, LVEF, LVDd and BNP were significantly improved in groupⅠ(P<0.05); 4 weeks after treatment, HFC, LVEF, LVDd, BNP and cTnI were significantly improved in groupⅡ(P<0.05), but LVDd and cTnI were still significantly higher in groupⅡ than those in groupⅠ(P<0.05). BNP had a high relation with LVDd in groupⅠ(r=0.871)and a middle relation in group Ⅱ(r=0.619). cTnI had a positive relation with LVDd in groupⅡ(r=0.629). Conclusion: Comprehensive evaluation of BNP and cTnI can be used not only to understand the heart function and left ventricular remodeling but also to predict the effect of treatment in patients with congestive heart failure, and thus provide a guidance for further therapy.

关 键 词：心力衰竭 充血性 脑钠素 心肌肌钙蛋白Ⅰ 

分 类 号：R541.61[医药卫生—心血管疾病]