心力衰竭患者血浆脑钠肽、内皮素-1与左心室功能的相关性分析  

Relationship of Brain Natriuretic Peptide and Endothelin-1 to Left Ventricular Function in Patients with Heart Failure

作　　者：谢玮[1] 王美珍[1] 李玲辉[1] 

机构地区：[1]南昌大学医院内科,南昌330006

出　　处：《南昌大学学报（医学版）》2013年第3期47-50,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的分析冠状动脉粥样硬化性心脏病(冠心病)心力衰竭患者脑钠肽(brain natriuretic peptide,BNP)、内皮素-1(endothelin-1,ET-1)与左心室心功能的相关性。方法使用全自动生化分析仪、采用酶联免疫吸附法检测50例冠心病左心衰竭患者(试验组)、50例健康体检者(对照组)血浆BNP水平,使用全自动生化分析仪、采用放射免疫法检测血浆ET-1水平,以彩色多普勒超声心动仪测定左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)。试验组患者随访12～21个月,观察心血管事件的发生及血浆BNP、ET-1水平的变化情况。结果试验组患者血浆BNP、ET-1水平均显著高于对照组(均P<0.05);与对照组比较,试验组患者LVEF值显著降低,LVEDD值显著升高(P<0.05)。试验组患者血浆BNP水平与血浆ET-1水平及LVEDD呈正相关(r=0.627、0.601,均P<0.01),血浆BNP水平与LVEF呈负相关(r=-0.532,P<0.01),血浆ET-1水平与LVEDD呈正相关、与LVEF呈负相关(r=0.415、-0.437,均P<0.05)。31例未发生心血管事件的患者血浆BNP水平显著低于19例发生心血管事件的患者(P<0.05)。结论血浆BNP、ET-1水平与心力衰竭严重程度有明显相关性,血浆BNP水平对再发心血管事件具有预测作用。Objective To explore the relationship of brain natriuretic peptide（BNP） and endothelin-1（ET-1） to left ventricular function in patients with heart failure caused by coronary atherosclerotic heart disease.Methods Plasma BNP levels were measured by enzyme linked immunosorbent assay and ET-1 levels were detected by radioimmunoassay with automatic biochemical analyzer in 50 patients with left ventricular failure caused by coronary heart disease（experimental group） and 50 healthy subjects（control group）.Left ventricular ejection fraction（LVEF） and left ventricular end-diastolic diameter（LVEDD） were determined by color Doppler echocardiography.Patients in experimental group were followed-up for 12-21 months to observe the occurrence of cardiovascular events and the changes in BNP and ET-1 levels.Results Compared with control group,plasma BNP and ET-1 levels and LVEDD significantly increased but LVEF obviously decreased in experimental group（P0.05）.Plasma BNP levels in patients with left ventricular failure were positively correlated with ET-1 levels and LVEDD（r=0.627 and r=0.601,respectively;P0.01）,but negatively correlated with LVEF（r=-0.532,P0.01）.Plasma ET-1 levels were positively correlated with LVEDD levels and negatively correlated with LVEF（r=0.415 and r=-0.437,respectively;P0.05）.Compared with the 19 patients with cardiovascular disease,plasma BNP levels significantly decreased in the 31 patients without cardiovascular disease（P0.05）.Conclusion Plasma levels of BNP and ET-1 are obviously correlated with the severity of heart failure.Plasma BNP plays a role in the prediction of recurrent cardiovascular events.

关 键 词：冠状动脉粥样硬化性心脏病 心力衰竭 脑钠肽 内皮素-1 左心室射血分数 左心室舒张末期内径 

分 类 号：R54[医药卫生—心血管疾病] R541[医药卫生—内科学]