慢性心力衰竭患者血浆氨基末端脑钠素前体水平对病情的评估  

Levels of N-terminal portion of brain natriuretic in patients with chronic left heart failure and the prodictive value on clinical condition

作　　者：汪芳[1] 黄洁[1] 庞会敏[1] 边文彦[1] 王莉[1] 明广华[1] 顼志敏[1] 李一石[1] 

机构地区：[1]中国医学科学院阜外心血管病医院临床药理中心卫生部心血管药物临床研究重点实验室,北京100037

出　　处：《临床心血管病杂志》2006年第7期407-409,共3页Journal of Clinical Cardiology

基　　金：国家863计划"十五"重大科技专项"药物临床试验关键技术平台研究"课题(No:2002AA2Z341A)

摘　　要：目的:探讨氨基末端脑钠素前体(NT-proBNP)水平对慢性心力衰竭患者病情评估的临床价值。方法:选择慢性心力衰竭患者135例,以NYHA方法评估其心功能,部分患者行超声心动图检查测定左室射血分数(LVEF);采用ELISA法测定NT-proBNP水平,放射免疫法测定肾素-血管紧张素-醛固酮系统激素水平。结果:随着心功能级别增高,NT-proBNP水平递增,Ⅰ级(1例)、Ⅱ级(47例)、Ⅲ级(65例)和Ⅳ级(22例)的NT-proB-NP水平分别为61、746、1668和4720ng/L。各级间均差异有统计学意义(P<0·01)。血管紧张素原、肾素、血管紧张素Ⅱ及醛固酮的血浆水平,随心功能或LVEF变化不显著或无规律性。结论:NT-proBNP水平对于慢性心力衰竭患者的病情评估具有较高的价值,且优于肾素-血管紧张素-醛固酮系统激素。Objective：To evaluate the levels of NT-proBNP and its clinical value in patients with chronic left heart failure （CHF） with different NYHA class. Method.. Patients （aged 18-80 years） with chronic left heart failure were included in this study , who were from the Dept. of inpatient , emergence room or outpatient in our hospital. Plasma concentrations of the N-terminal portion of brain natriuretic （NT-proBNP）, rennin activity （PRA）, angiotensin Ⅱ （AT Ⅱ ） and aldosterone（Aldo） were detected by ELISA or RIA assay. Result： One hundred and thirty-five patients with chronic left heart failure were included in this study. The median levels of NT- proBNP increased gradually in 135 patients with chronic left heart failure, which associated with NYHA heart function classes increased by degrees; that was, M value of NT proBNP was 61 ng/L in NYHA class Ⅰ （ n =1）, 746 ng/L in class Ⅱ （ n =47）, 1668 ng/L in class Ⅲ （ n =65）, and 4720 ng/L in class Ⅳ group （ n =22）. They were different statistics significantly among different classes. While there were theincreasing trend of NT- proBNP levels associated with the decreasing of left ventricular ejection fraction （LVEF） by echocardiography in 88 cases from above 135 cases （ P〉0.05）, but the levels of AO, PRA, ATⅡ and Aldo had no significant association with NYHA classes or LVEF. Conclusion：The levels of NT-proBNP in patients with chronic left heart failure can assess disease severity, which maybe superior to RAAS hormones.

关 键 词：心力衰竭 氨基末端脑钠素前体 肾素-血管紧张素-醛固酮系统 

分 类 号：R541.6[医药卫生—心血管疾病]