慢性心力衰竭患者6min步行试验与血清脑利钠肽水平的临床研究  

Clinical study on the six-minute walk test and serum brain natriuretic peptide levels in patients with chronic heart failure

作　　者：陈协兴[1] 洪华山[1] 陈良龙[1] 郑关毅[2] 王一波[1] 江琼[1] 董现锋[1] 

机构地区：[1]福建医科大学附属协和医院心内科 [2]福建医科大学附属协和医院中医科

出　　处：《中国临床药理学与治疗学》2004年第5期561-564,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的 :通过对慢性心力衰竭患者的 6min步行试验 (6MWT)的距离和血清脑利钠肽 (BNP)水平的观察 ,探讨 6MWT和BNP水平对心力衰竭患者心脏功能评估的临床意义。方法 :测量 5 1例慢性心力衰竭患者 (心衰组 )的 6MWT距离和酶联免疫吸附法检测血清BNP 32浓度。并以 30例健康成人为对照组。结果 :心衰组的 6MWT距离 380 .3± 12 1.7m明显低于对照组 5 46 .8± 12 8.5m (P <0 .0 1)。心衰组BNP水平 75 8.3± 2 89.5ng·L-1明显高于对照组10 9.3± 37.6ng·L-1(P <0 .0 1)。NYHA心功能Ⅱ级的 6MWT距离 4 2 5 .0± 10 5 .8m明显低于Ⅲ级335 .6± 12 6 .1m (P <0 .0 1)。NYHAⅡ级的BNP水平 6 38.5± 2 2 4 .5ng·L-1明显高于Ⅲ级 878.0±334.0ng·L-1(P <0 .0 1)。 6MWT距离 <30 0、30 0～374 .9、375～ 4 49.9和 <4 5 0m患者的BNP水平分别为 988.9± 2 0 2 .6、76 8.6± 2 17.4、6 5 7.5± 185 .0和5 0 6 .9± 198.4ng·L-1(P <0 .0 1) ;6MWT的距离与BNP水平呈负相关 (r =- 0 .75 2 ,P <0 .0 1)。结论 :6MWT和BNP水平测定对慢性心力衰竭患者的心脏功能评估具有重要临床意义。AIM: To investigate clinical significance of Six-Minute Walk Test (6MWT) and serum brain natriuretic peptide (BNP) levels in evaluating heart function in patients with chronic heart failure (CHF). METHODS: 51 patients with CHF (CHF group) and 30 healthy subjects served as control group were involved in the trials. The distance walked in six-minute and the serum levels of BNP-32 by enzyme-linked immunosorbent assay method were observed. The differences among 6MWT distance,BNP levels and different NYHA classes were analysed. RESULTS: The 6MWT distances in CHF group and control group were 380.3 ± 121.7 and 546.8 ± 128.5 m ,respectively (P< 0.01 ). The serum levels of BNP in CHF group and control group were 758.3 ± 289.5 and 109.3 ± 37.6 ng·L -1 ,respectively (P< 0.01 ). The 6MWT distances in NYHA classⅡand Ⅲ of CHF patients were 425.0 ± 105.8 and 335.6 ± 126.1 m ,respectively (P< 0.01 ). The BNP levels in NYHA classⅡand Ⅲ of CHF patients were 638.5 ± 224.5 and 878.0 ± 334.0 ng·L -1 ,respectively (P< 0.01 ). BNP levels in CHF patients of 6MWT distances among below 300,300- 374.9 ,375- 449.9 and above 450 m was 988.9 ± 202.6 , 768.6 ± 217.4 , 657.5 ± 185.0 and 506.9 ± 198.4 ng·L -1 ,respectively (P< 0.01 ). The 6MWT distance was inversely correlated to the BNP level (r=- 0.752 ,P< 0.01 ). CONCLUSION: Not only 6MWT distances but also serum BNP levels have an important clinical value in evaluating heart function of CHF.

关 键 词：心力衰竭 6分钟步行试验 利钠肽 脑 诊断 心脏功能评估 

分 类 号：R514.61[医药卫生—内科学]