收缩性心力衰竭患者血浆脑钠肽水平与左心室舒张功能及二尖瓣返流程度相关性研究  

Relationship of plasma B-type natriuretic peptide levels to echocardiographic diastolic indexes and mitral regurgitation in patients with systolic heart failure

作　　者：周炳元[1] 程绪杰[1] 杨向军[1] 杨俊华[1] 李红霞[1] 宋建平[1] 蒋文平[1] 

机构地区：[1]苏州大学附属第一医院心内科,江苏苏州215006

出　　处：《医学研究生学报》2005年第B05期64-68,共5页Journal of Medical Postgraduates

摘　　要：目的:研究收缩性心力衰竭(SHF)患者左心室舒张功能及二尖瓣返流严重程度与血浆脑钠肽(BNP)水平相关性。方法:62例SHF患者(左心室射血分数LVEF<0.40)进行超声心动图检查,评价其二尖瓣返流程度,根据二尖瓣口舒张期血流和肺静脉血流评价左心室舒张功能,同时进行血浆BNP检测。结果:随左心室舒张功能及二尖瓣返流严重程度增加,血浆BNP水平均明显增高(P<0.01)。血浆BNP水平与左心室舒张功能参数[E峰下降时间(DT),r=-0.37;肺静脉收缩期流速峰值(S峰),r=-0.47;舒张期流速峰值(D峰),r=0.38;D/S,r= 0.61]均呈显著相关(P<0.01)。结论:SHF患者中,左心室舒张功能及二尖瓣返流严重程度与血浆BNP水平密切相关,联合检测有助于病情了解,明确患者预后。Objective : This study was designed to characterize the relationship of plasma B-type natri uretie peptide ( BNP) levels to echocardiographic diastolic indexes and mitral regurgitation (MR) in patients with systolic heart failure. Methods:In 62 patients with symptomatic SHF [left ventricular ejection fraction (LVEF) <0. 40] , we measured plasma BNP levels and performed comprehensive echocar-diography with assessment of left ventricular diastolic function, including transmitral diastolic flow and pulmonary venous flow. Results: Median plasma BNP levels increased with greater severity of diastolic dysfunction, as well as severity of mitral regurgitation . We found significant correlations (P<0.01 for all) between BNP and indexes of diastolic function [early deceleration time(DT) ,r = -0. 37; systolic flow of pulmonary venous (S) , r = - 0. 47 ; diastolic flow of pulmonary venous ( D ) , r = 0. 38 ; D/S ratio, r=0.61 ]. Conclusion :Plasma BNP levels are significantly related to diastolic indexes measured from transmitral diastolic flow and pulmonary venous flow. Heterogeneity of BNP levels in patients with SHF reflects the severity of diastolic abnormality, and MR in addition to LVEF. These findings may explain the powerful relationship of BNP to symptoms and prognosis in SHF.

关 键 词：B型脑钠肽 超声心动图 舒张功能 心力衰竭 二尖瓣返流 

分 类 号：R541.61[医药卫生—心血管疾病]