血浆B型钠尿肽水平对冠心病左心室收缩功能不全的诊断价值  

The diagnostic value of B-type natriuretic peptide for left ventricular dysfunction in patients with coronary heart disease

作　　者：杨峻[1] 王咏梅[2] 黄丽娜[2] 蒲红[2] 姜小华[1] 方晓云[1] 孔宪涛[3] 

机构地区：[1]解放军第85医院检验科,上海200052 [2]解放军第85医院心内科,上海200052 [3]第二军医大学附属长征医院,上海200003

出　　处：《检验医学》2005年第5期434-436,共3页Laboratory Medicine

摘　　要：目的研究冠心病患者血浆B型钠尿肽(BNP)水平与左心室收缩功能的关系.方法用免疫发光法检测30名正常对照者与69例冠心病患者血浆BNP水平,通过纽约心脏病协会心功能分级标准(NYHA)及超声心动图结果对冠心病患者心功能分级.结果对照组、心功能Ⅰ～Ⅱ级组及心功能Ⅲ～Ⅳ级组的BNP水平分别为(31.56±21.48) μg/L、(105.52±91.77) μg/L和(433.18±378.03)μg/L,3组差异均有非常显著性(P<0.001).冠心病患者BNP水平与左室射血分数(LVEF)呈负相关(r=-0.70,P<0.001),其中LVEF≤40%亚组BNP水平显著高于LVEF>40%亚组(P<0.01).结论血浆BNP水平能反映冠心病患者左心室收缩功能,该指标对早期心功能不全患者的检出、心力衰竭程度的评判等具有重要的临床价值.Objective To study the relationship between the plasma level of B-type natriuretie peptide（BNP） and the left ventrieular function in patients with coronary heart disease. Methods BNP levels in plasma of 30 nomal controls and 69 patients with coronary heart disease were measured by ehemilumino-immunoassay. The ventrieular function was measured by NYHA and colored doppler eehoeardiography. Results The BNP concentrations in control group, ventrieular function （ Ⅰ - Ⅱ ） group and ventrieular function （ Ⅲ-Ⅳ ） group were （ 31.56 ± 21.48） μg/L, （ 105.52 ± 91.77） μg/L and （433.18 ± 378.03 ）μg/L respectively. There was statistical significance among these groups（P 〈 0. 001 ）. The levels of plasma BNP and the left ventrieular ejeetive fraction （LVEF） had a significant negative correlation （r = -0.70, P 〈0. 001 ）. BNP levels of LVEF≤40% subgroup were significantly higher than those of LVEF 〉 40% subgroup （P 〈0.01 ）. Conclusions BNP level reflects the left ventrieular function in patients with coronary heart disease. The determination of BNP has important value in the diagnosis of early ventrieular dysfunction and the evalua- tion of the severity of cardiac failure.

关 键 词：B型钠尿肽 C反应蛋白 冠状动脉粥样硬化性心脏病 心功能不全 

分 类 号：R446.1[医药卫生—诊断学]