B-型利钠肽的研究进展及其在心血管领域的临床应用  

Research Advances in B-type Natriuretic Peptide and Its Clinical Application in the Patients with Cardiovascular Diseases

作　　者：张忠玲[1] 毛静远[2] 

机构地区：[1]天津中医药大学研究生部,天津300193 [2]天津中医药大学第一附属医院心内科,天津300193

出　　处：《中国医学科学院学报》2012年第2期183-189,共7页Acta Academiae Medicinae Sinicae

基　　金："十一五"国家科技支撑计划(2006BAI08B02-01)~~

摘　　要：B-型利钠肽(BNP)是左室功能障碍和心脏容量负荷过重的血浆标志物,目前主要应用于心血管领域。BNP是胚胎干细胞增殖的内在调控子,BNP减少可增加细胞凋亡的速度,N端脑钠肽前体-BNP的抗原表位最稳定。BNP1-32是所有BNP中生物活性最强的,但在心力衰竭患者的血浆水平较低。血浆BNP水平对心力衰竭的诊断、预后、再入院和死亡的预测发挥重要作用,并可以指导和用于心力衰竭治疗。心力衰竭患者Ⅱ型跨膜丝氨酸蛋白酶的缺乏导致未能裂解的脑钠肽激素前体-BNP升高。BNP也可以为其他人群和疾病提供诊断和预后信息,对BNP及其受体的基因水平的研究有助于提高和改善BNP作为生物标志物的重要作用,目前,由利钠肽合成的促尿钠排泄肽、中性内肽酶抑制剂、血管肽酶抑制剂用于治疗心血管功能紊乱。BNP和N端脑钠肽前体-BNP的检测手段尚有待于进一步提高。B-type natriuretic peptide（BNP） is a plasma marker of left ventricular dysfunction and cardiac volume overload.Currently it is mainly used in the cardiovascular field.BNP is an intrinsic regulator of the embryonic stem cell proliferation,and the reduction in BNP can increase the apoptosis rate.The epitope of N terminal pro-brain natriuretic peptide-BNP is most stable.BNP1-32 has the strongest biological activity but with lower plasma level in heart failure patients.The plasma BNP level plays an important role in the diagnosis,prognosis,hospital admission and mortality of heart failure,and can be used as a monitoring indicator in the treatment of heart failure.The deficiency of corin enzyme in patients with heart failure can cause the increase of cracking pro-BNP.BNP can also provide diagnostic and prognostic information for other populations and diseases. Genetic studies on BNP and its receptors also provide important information.Nesiritide,neutral endopeptidase inhibitors,and vasopeptidase inhibitors of the natriuretic peptide synthesis have been used for the treatment of cardiovascular disorders.However,more reliable and accurate approaches for detecting BNP and N terminal pro-brain natriuretic peptide-BNP require further investigations.

关 键 词：B-型利钠肽 心力衰竭 

分 类 号：R541[医药卫生—心血管疾病]