血浆脑钠素筛查对糖尿病早期心肌病变的意义  

Screening of early cardiomyopathy with plasma brain natriuretic peptide in diabetic patients with left ventricular diastolic dysfunction

作　　者：吴天凤[1] 郑和昕[1] 袁放[1] 江缨[1] 叶萌[2] 周欢琴[3] 

机构地区：[1]浙江医院内分泌科,杭州310013 [2]浙江医院B超室,杭州310013 [3]浙江医院检验科,杭州310013

出　　处：《浙江医学》2012年第13期1117-1119,共3页Zhejiang Medical Journal

基　　金：浙江省老年重点学科招标项目（20（）7ZB012）

摘　　要：目的探讨血浆脑钠素（BNP）对评估糖尿病左心室舒张功能不全患者早期心肌病变的意义。方法采用脉冲多普勒超声心动图评估糖尿病患者左心室舒张功能（LVDD）并分组，采用免疫荧光法检测血浆BNP水平。结果与对照组及正常组相比，异常组心肌重量增加，血浆BNP水平明显升高（P〈0．01），与LVDD不全程度呈负相关。BNP识别糖尿病LVDD不全的最佳切点为10．05pg／ml。结论血浆BNP联合脉冲多普勒超声心动图左心室舒张功能检测能提高诊断糖尿病LVDD不全的准确度，当BNP≥10．05pg／ml时，应进一步行脉冲多普勒超声心动图明确有无LVDD不全。血浆BNP可能可以成为评估早期糖尿病心肌病变发生的指标。Objective To assess screening of early cardiomyopathy with plasma brain natriuretic peptide （BNP） in dia- betic patients with left ventricular diastolic dysfunction （LVDD）＋ Methods Left ventricular systolic and diastolic function was e- valuated by pulsed Doppler ultrasonography in diabetic patients. Plasma BNP levels were measured by immunofluorescence method in 70 diabetic patients with abnormal LVDD, 31 patients with normal LVDD and 30 healthy subjects. Results Compared to normal controls and diabetics with normal left ventricular diastolic function, plasma BNP levels were significantly elevated in LVDD group （P〈0.01）. BNP levels were negatively correlated with LVDD （P〈0.05）. The optimal cut-off BNP level to identify type 2 diabetes with LVDD was 10.05pg/ml. Conclusion Plasma BNP level can be used for screening of early cardiomyopathy in diabetic patients with left ventricular diastolic dysfunction, and patients with BNP ≥ 10.05 pg/ml are recommended to undergo pulsed Doppler ultrasound examination.

关 键 词：糖尿病 利钠肽 脑 左心室舒张功能 

分 类 号：R587.1[医药卫生—内分泌]