血浆B型脑钠肽在不同病因及类型心力衰竭中的变化及意义  

Clinical Significance of Changes in Plasma B-type Natriuretic Peptide of Patients with Different Etiology and Type of Heart Failure

作　　者：赵磊[1] 张鹏飞[1] 张鹏翔[1] 王丽娟[1] 孙英贤[1] 

机构地区：[1]中国医科大学附属第一医院心内科,沈阳110001

出　　处：《中国医科大学学报》2013年第12期1079-1082,共4页Journal of China Medical University

基　　金：辽宁省教育厅高校科研计划(L2012286)

摘　　要：目的探讨不同病因及类型心力衰竭(HF)患者血浆B型脑钠肽(BNP)浓度的变化及临床意义。方法测定137例急性心肌梗死(AMI)合并急性HF患者,287例慢性心力衰竭患者血浆BNP、超敏C-反应蛋白、肌钙蛋白等生化指标,并测定193例收缩性心力衰竭及180例舒张性心力衰竭患者血浆BNP浓度,同时评价心脏结构、心功能及冠状动脉病变,进行比较分析及相关分析。结果慢性HF患者血浆BNP浓度明显高于AMI合并急性心力衰竭组(P<0.05),不同病因慢性HF患者血浆BNP浓度存在明显差异,且随心力衰竭程度增加而升高。收缩性HF患者血浆BNP浓度明显高于舒张性HF(P<0.001)。AMI患者血浆BNP浓度与超敏C-反应蛋白、肌钙蛋白及冠状动脉狭窄支数呈正相关(P<0.05)。结论血浆BNP水平与HF的病因、程度及类型密切相关,因此,以BNP作为HF诊断的指标时要考虑不同病因及类型进行评价。Objective To investigate the clinical significance and changes of plasma B-type natriuietic peptide（BNP）in patients with different eti- ology and type of heart failure （HF）. Methods The plasma BNP, high sensitive C - reactive protein （ hs - CRP ） and troponin I （ cTnI ） concentration were determined in 137 cases of patients with acute myocardial infarction （ AMI ） accompanying acute heart failure and 287 cases of patients with chronic heart failure ; the plasma BNP concentration was determined in 193 cases of patients with systolic HF and 180 cases of patients with diastolic HF. In addition, the structure and function of heart, and coronary artery lesion were evaluated, compared and correlation analyzed. Results The plasma BNP concentration in patients with chronic heart failure was significantly higher than that in AMI group （P 〈 0.05 ） .There are obvious differ- ence in plasma BNP concentration in the patients with chronic heart failure of different etiology; the plasma BNP concentration increases significantly with the critical degree of heart failure. Plasma BNP concentration in patients with systolic HF was significantly higher than the patients with diastolic HF （P 〈 0.001 ）. Moreover, a positive correlation was observed between the plasma BNP and hs-CRP, cTnI concentration, and branch number of coronary artery stenosis in these patients with AMI （P 〈 0.05 ）. Conclusion Plasma BNP levels is closely related to the cause, the degree and the type of heart failure ; thus, the different causes and types of HF must be considered when we evaluating the HF on the basis of BNP level as HF diag- nostic standard.

关 键 词：心力衰竭 心肌梗死 脑利钠肽 

分 类 号：R541.6[医药卫生—心血管疾病]