心力衰竭患者脑钠肽变化与间质胶原及心功能的关系  

Correlation between B-natriuretic Peptide,Myocardial Collagen in and Cardiac Function Patients with Heart Failure

作　　者：武利军[1] 李飒[1] 佟秋艳[1] 王与章[1] 徐焰[2] 赵连友[2] 

机构地区：[1]中国人民解放军第二六四医院 [2]中国人民解放军第四军医大学唐都医院

出　　处：《中西医结合心脑血管病杂志》2009年第2期137-138,共2页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨心力衰竭患者B型脑钠肽(BNP)的变化及其与间质胶原及心功能的关系。方法选取心力衰竭患者47例(风湿性心脏病20例,扩张性心脏病7例,先天性心脏病20例)和5例正常心肌标本作对照,应用病理染色结合图像分析,RT-PCR测定心肌胶原容积分数(CVF)、BNP mRNA表达水平、超声心动图测量左室舒张末内径(LEVDD);免疫荧光法测定血浆BNP的含量,并和CVF及LEVDD作相关分析。结果心力衰竭患者心肌间质CVF明显高于正常对照组(P<0.01);心力衰竭患者心肌BNP mRNA表达水平较正常心肌明显增高(P<0.01);心力衰竭患者血浆中BNP的含量明显增高,心功能分级越高其升高越显著(P<0.01)。血浆BNP水平与CVF及LEVDD呈显著正相关(r分别为0.67、0.59,P<0.01)。结论心力衰竭患者血清BNP含量增高并能反应心肌纤维化和心功能降低程度,快速检查血浆BNP可以用来评估病情并反映预后。Objective To determine the correlation between the plasma B - natriuretic peptide and myocardial collagen and to evaluate the diagnosis values of BNP in patients（pts） with decompensatedheart failure. Methods The BNP levels were measured by an immunofluoresence assay in 47 pts with heart failure（20 pts with rheumatic heart disease, 7 pts with dilated cardiomyopathy and 20 pts with congenital heart diseases）. The myocardium specimens of all patients and 5 healthy adult were studied by Masson staining. The collagen volume fraction（CVF） of myocardial fibrosis was measured by imaging analysis system and the BNP mRNA levels were measured by RT - PCR. The left ventricular end - diastolic diameter（LVEDD） in all pts was measured by echocardiogram. Results The CVF in pts was significant more than that in control group（P〈0. 01）. The BNP mRNA levels in pts were significantly higher than that in control group（P〈0.01）. The plasma BNP levels were increased and related to cardiac function （P〈0.01）. The plasma BNP levels were correlate to the CVF and LVEDD（r=0. 67, 0.59, P〈0.01）. Conclusion The plasma BNP levels showed significant positive correlation with CVF and LVEDD. The result suggested that BNP was a cardiac neurohormone secreted from cardiac ventricles and might be used to evaluate the heart failure and to predict prognosis.

关 键 词：心力衰竭 胶原 脑钠尿肽 

分 类 号：R541.6[医药卫生—心血管疾病] R256.2[医药卫生—内科学]