慢性心力衰竭患者血浆脑纳肽、血清心肌肌钙蛋白I与心室重构的相关性研究  

Correlation between the plasma B-type natriuretic peptide, cardiac troponin I and ventricular remodeling in patients with congestive heart failure

作　　者：徐兵[1] 李泽浦[1] 姜懿[1] 秦端[1] 陶凌[1] 石晓凤[1] 张奕[1] 

机构地区：[1]复旦大学附属华山医院宝山分院心内科,上海市200431

出　　处：《中国心血管病研究》2010年第3期190-193,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨充血性心力衰竭（CHF）患者血浆B型脑钠肽（BNP）、血清心肌肌钙蛋白I（cTnI）水平与左心室质量比值（PLM）和平均室壁应力（MWS）的相关性。方法将116例CHF患者作为心衰组，同期选择32例健康体检者作为对照组。检测血浆BNP和血清cTnI水平，评价心功能，超声心动图测量左心室射血分数（LVEF），计算PLM和MWS。结果与对照组比较，心衰组患者BNP和cTnI水平升高。随着心功能分级程度的加重和疾病的进展，BNP和cTnI水平逐渐升高，BNP与cTnI呈正相关，与LVEF呈负相关（P〈0．01）。MWS和PLM随心力衰竭程度的加重而增高，并与LVEF呈负相关（P〈0．01），与BNP和cTnI水平呈正相关（P〈0．01）。结论血浆BNP与cTnI水平的增加与PLM和MWS增加有关，可作为诊断CHF心室重构无创、方便、快捷的生化指标和预后指标。Objective To explore the correlation among the plasma B-type natriuretic peptide （BNP） level, serum cardiac Troponin I （cTnI） level, left ventricular mass （PLM） index and left ventricular mean wall stress（MWS） in patients with congestive heart failure（CHF）. Methods 166 patients diagnosed with CHF were recruited as the experimental group, and 32 healthy people coming to the same hospital for health checkup served as the control group. Plasma BNP level, serum cTnI level were tested, cardiac function assessment was conducted, and echocardiography was employed for quantifying left ventricular volume （LVEF）. Furthermore, PLM index and MWS were calculated. Results Compared to the control group, the experimental group exhibited higher levels of plasma BNP and serum cTnI, and the levels of plasma BNP and serum cTnI rose correspondingly when cardiac function worsened and the disease progressed more seriously. BNP was positively correlated with cTnI, while in- versely correlated with LVEF （P〈0.01）. As the severity of heart failure became more serious, MWS and PLM rose correspondingly, inversely correlated with LVEF, whereas positively correlated with BNP and eTnI （P〈0.01）. Conclusion Higher levels of plasma BNP and serum cTnI are associated with the increase of PLM and MWS. They could serve both as non-intrusive convenient biochemical indicators for CHF ventricular remodeling, and indicators of CHF prognosis evaluation.

关 键 词：心力衰竭 充血性 心室重构 B型钠尿肽 心肌肌钙蛋白 

分 类 号：R541.6[医药卫生—心血管疾病]