大内皮素-1和氨基末端脑钠肽前体与重度充血性心力衰竭相关性的临床观察  

The clinical observation at diagnosing severe congestive heart failure by big endothelin-1 and the amino-terminal pro-brain natriuretic peptide

作　　者：过高峰 周琼[2] 

机构地区：[1]蒙城县第一人民医院干部病房,安徽省233500 [2]中国医学科学院阜外心血管病医院心衰病房

出　　处：《中国心血管病研究》2012年第9期672-675,719,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨重度充血性心力衰竭（CHF）患者血浆大内皮素-1（BigET-1）和氨基末端脑钠肽前体（NT-proBNP）的变化规律及其与心功能的相关性.方法 将90例CHF患者分为轻度组与重度组.轻度组为美国纽约心脏病协会（NYHA）心功能分级Ⅰ～Ⅱ级的42例CHF患者,重度组为NYHA心功能分级Ⅲ～Ⅳ级的48例CHF患者.用酶联免疫吸附实验双抗体夹心法测定两组患者血浆BigET-1和NT-proBNP水平,并分析二者关系;彩色心脏超声测定左心室功能参数：左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）和左室射血分数（LVEF）,并分析实验室指标与左心室功能参数的相关性.结果 重度组血浆BigET-1与NT-proBNP含量显著高于轻度组,差异有统计学意义[（2.13±0.58）fmol/ml比（1.08±0.35）fmol/ml,P＜0.01,（2885.2±1299.2）fmol/ml比（1165.8±333.2）fmol/ml,P＜0.01].重度组血浆BigET-1含量与LVEF、LVEDD、LVESD密切相关（r分别为-0.740、0.655和0.740,P均＜0.01）; NT-proBNP含量与LVEF、LVEDD、LEVSD有良好相关性（r分别为-0.670、0.654、0.709,P均＜0.01）;血浆BigET-1与NT-proBNP也密切相关（r＝0.752,P＜0.01）.结论 BigET-1和NT-proBNP可能参与了心功能损伤的病理生理过程.快速检测BigET-1和NT-proBNP对CHF的实验室诊断、心功能评估、疗效观察、预后判断均具有重要临床价值.Objective To explore the variation of plasma big endothelin-1 （BigET-1 ） and amino-ter-minal pro-brain natriuretic peptide precursor （NT-proBNP） in patients with severe congestive heart failure （CHF） and their correlation with cardiac function. Methods 90 cases congestive heart failure patients were divided into severe group and mild group, severe group were 48 case congestive heart failure patients [New York Heart Asso-ciation （NYHA） functional classification grade Ⅲ-Ⅳ）], and the mild group was NYHA grade Ⅰ -Ⅱpatients with congestive heart, plasma BigET-1 and NT-proBNP level detected by enzyme linked immunosorbent assay （ELISA）-sandwich technique, and the relationship between BigET-1 and NT-proBNP was analyzed. Left ventricu- lar function parameters such as Left ventrieular end-diastolic diameter （LVEDD）, left ventricular end systolic di-ameter （LVESD） and left ventricular ejection fraction （LVEF） were detected by echoeardiography, and the labora-tory parameters and left ventrieular function parameters were analyzed. Results Plasma BigET-1 and NT-proBNP levels in severe group were significantly higher than that of mild group, which was statistically significant [ （2.13± 0.58）fmol/ml vs （ 1.08±0.35 ）fmol/ml, P〈0.01, （2885.2±1299.2）fmol/ml vs （ 1165.8±333.2）fmol/ml, P〈0.01 ], plasma BigET-1 levels and in LVEF, LVEDD, LVESD in experimental group were significantly correlated （r=-0.740, 0.655 and 0.740, respectively, all P〈0.01 ）, level of NT-proBNP and LVEF, LVEDD, LVESD was sig-nificantly correlated （r=-0.670, 0.654, 0.709, respectively all P〈0.01 ）, the plasma BigET-1 and NT-proBNP was also closely related （r=0.752, P〈0.01 ）. Conclusion BigET-1 and NT-proBNP may be involved in the pathophysiological process of heart dysfunction. The rapid detection of CHF by laboratory diagnosis is important in clinical practice, such as cardiac function assessment, effect and prognosis.

关 键 词：心力衰竭 大内皮素-1 氨基末端脑钠肽前体 

分 类 号：R541.61[医药卫生—心血管疾病]