血浆脑钠肽水平在心力衰竭诊断中的应用价值  

Plasma BNP levels in heart failure diagnosis.

作　　者：罗嘉宏[1] 梁茜[2] 

机构地区：[1]佛山市禅城区张槎医院,广东佛山528000 [2]中山大学附属佛山医院,广东佛山528000

出　　处：《临床和实验医学杂志》2010年第13期966-967,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的研究血浆脑钠肽(BNP)在诊断心力衰竭尤其是早期心力衰竭中的作用,观察BNP水平与纽约心脏病学会(NYHA)心功能分级及心脏超声指标的相关性;评价血浆BNP水平对心力衰竭患者不良心血管事件发生率的预测价值。方法选取2007年10月至2009年10月在我院住院的168例慢性心力衰竭(CHF)患者,随机选择我院健康体检人员168例作为对照组。分析BNP水平与患者心功能状态、心脏超声指标的关系。结果心衰组中各心功能分级组间的BNP浓度、左室射血分数(LVEF)比较,差异有统计学意义(P<0.01)。LVEF与BNP呈显著负相关(r=-0.708,P<0.01)。BNP诊断心衰的灵敏度为56.1%。按心衰分级的灵敏度,分别为Ⅰ级9.5%、Ⅱ级38.9%、Ⅲ级55.6%、Ⅳ级83.3%。结论 BNP测定是辅助诊断心功能不全的有效方法,尤其是在心力衰竭早期,BNP水平还可以反映心功能不全的严重程度,并对心力衰竭患者进行心功能分级的一个较好的实验室指标。Objective To investigate the value of plasma brain natriuretic peptide （BNP） level for the diagnosis, especially early diagnosis of heart failure （HF） and for predicting adverse cardiovascular events in patients with congestive heart failure （CHF）, and the relevance of BNP level, and New York Heart Association （NYHA） class and cardiac ultrasound. Methods One hundred and sixty- eight eases of CHF patiants hospitalized between October 2007 and October 2009 were randomly selected. 168 healthy medical staffs were assigned as control. BNP level, cardiac function and cardiac ultrasound results were analyzed. Results The differences of plasma BNP level and LVEF among different cardiac function groups of CHF patients were statistically significant （ P 〈 0.01 ）. LVEF and BNP was negatively correlated （ r = - 0.708, P 〈 0.01 ）. The diagnostic sensitivity of BNP for heart failure was 56.1%. The corresponding sensitivities for NYHA class I through IV were 9.5%, 38. 9%, 55.6%, and 83.3 % respectively. Conclusion BNP measurement may assist the diagnosis of cardiac dysfunction in an effective way, especially in the early stage of heart failure. BNP level may also reflect the severity of cardiac dysfunction and serve as a better grading indicator of cardiac function in heart failure patients.

关 键 词：脑钠肽 心力衰竭 诊断 

分 类 号：R541.6[医药卫生—心血管疾病]