西宁地区老年心力衰竭患者血浆脑钠肽和炎性因子水平变化的分析  

Analysis of changes of BNP,CRP and TNF-α plasma levels of aged heart failure patients in Xining area

作　　者：李英兰[1] 郗爱旗[1] 楮以德[1] 朱爱琴[1] 李国峰[1] 尚玲[1] 于永才[1] 

机构地区：[1]青海省人民医院老年医学研究所,西宁810007

出　　处：《中华老年心脑血管病杂志》2008年第8期588-590,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的 探讨西宁地区（海拔2260米以上）老年心力衰竭患者血浆脑钠肽（BNP）、C反应蛋白（CRP）、TNF—α水平变化的临床意义。方法 将65例心力衰竭患者分为心衰组，同期选择34例健康体检者为对照组。采用美国博适Triage干式快速定量心力衰竭诊断仪检测血浆BNP水平、放射免疫法测定TNF-α水平、ELISA法测定CRP水平，同时行心脏超声检查。20例NYHA Ⅱ～Ⅳ级患者，常规抗心力衰竭治疗平均3个月后再次接受上述检查并留取血标本。结果 （1）心衰组患者血浆BNP、CRP、TNF-α水平明显高于对照组，差异显著（P〈0．01）；（2）NYHAⅡ～Ⅳ级患者血浆BNP水平较治疗前明显下降；（3）心衰组患者血浆BNP水平在NYHA不同级别之间差异显著，与NYHA呈正相关（r=0．458，P〈0．01），与LVEF呈负相关（F=-0．715，P〈0．01）。结论 血浆BNP、CRP、TNF—α参与了心力衰竭的发病过程，监测上述指标，可预测心力衰竭患者远期NYHA恢复情况，也可作为疗效观察及判定的重要参数。Objective To investigate B-type natriuretic peptide（BNP）, C-reactive protein （CRP） and TNF-α plasma levels of aged heart failure（HF） patients in Xining area（2260m above sea level）. Methods HF group included 65 patients and control group included 34 healthy volunteers. The levels of plasma BNP,CRP and TNF-α levels were measured. LVDd and LVDs were determined by echocardiography and left ventricular ejection fraction （LVEF） was calculated. Furthermore,blood BNP, CRP and TNF-α levels of 20 patients were retested after three months of anti- HF treatment. Results （1） The levels of serum BNP, CRP and TNF-α were much higher in aged HF group than in control group （P 〈 0.01）. （2）With the improving of heart function, the level of BNP declined obviously. （3） Serum BNP level had significant positive correlation with NYHA class （r = 0. 458, P 〈0.01） and negative correlation with LVEF （F =- 0. 715, P〈 0.01） in chronic heart failure（CHF） patients. Conclusion The plasma levels of BNP, CRP and TNF-α are significantly increased and correlated with NYHA class, as well as with prognosis in HF patients. The levels of BNP, CRP and TNF-α has important value in diagnosis, treatment and prognosis of patients with CHF.

关 键 词：心力衰竭 充血性 利钠肽 脑 C反应蛋白质 肿瘤坏死因子Α 

分 类 号：R541.6[医药卫生—心血管疾病]