心力衰竭患者血浆BNP水平变化与心力衰竭程度\心功能分级的相关性(1)
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[摘要] 目的：分析心力衰竭患者血浆BNP水平与其NYHA心功能分级、左室舒张末内径(LVEDD)、左室射血分数(LVEF)相关性，为临床评估及早期诊断心力衰竭提供客观依据。方法：选择45例NYHA心功能分级为Ⅲ~Ⅳ级的心力衰竭患者，在入院、出院时测定其血浆BNP、LVEDD、LVEF，选择45例健康人作为正常对照组。对上述检测指标进行组内、组间对比。结果：心力衰竭患者BNP水平高于正常对照组，与心功能分级具有相关性，与LVEDD、LVEF具有相关性，患者BNP水平出院时明显降低。结论：血浆BNP可以筛查心脏疾病，判断左心室收缩、舒张障碍，客观反映心力衰竭的程度，并且与NYHA分级具有良好的相关性，在心力衰竭患者治疗中也显示出很好的应用。
[关键词] B型脑钠肽；心力衰竭；心功能；相关性
[中图分类号] R541.6 [文献标识码]A[文章编号]1674-4721(2011)04(c)-044-02
Correlation of plasma BNP levels, the degree of heart failure and NYHA in patients with heart failure
LI Xiaonan
Emergency Department of Guicheng Hospital of Nanhai District, Guangdong Province, Foshan 528200, China
[Abstract]Objective: To analyze the plasma BNP levels in heart failure patients with NYHA functional class, LVEDD, LVEF correlation of clinical assessment and provide an objective basis for early diagnosis of heart failure. Methods: 45 patients with NYHA functional class Ⅲ-Ⅳ class for the heart failure patients, who were measured plasma BNP, LVEDD, LVEF at admission, discharge, 45 healthy people were selected as the normal control group. Detected indicators in and between the two groups. Results: Heart failure patients had BNP levels higher than the normal control group, and their cardiac function correlated with the LVEDD, LVEF relevant, BNP levels were significantly lower at discharge. Conclusion: Plasma BNP can be used for screening for heart disease, to determine left ventricular systolic and diastolic disorders, objectively reflect the degree of heart failure, a good correlation with NYHA classification and in the treatment of heart failure patients also showed a good application.
[Key words] B-type natriuretic peptide; Heart failure; Cardiac function; Correlation
B型脑钠肽(B-type brain natriuretic peptide，BNP)是一种广泛分布于脑、脊髓、心肺等组织的神经内分泌激素，心脏内BNP含量最高，主要由心室肌细胞分泌，心室压力负荷增加和容量扩张是刺激其分泌的主要因素[1]。此研究为探讨BNP与心力衰竭患者的NYHA分级、左室舒张末内径(LVEDD)、左室射血分数(LVEF)的相关性，为临床对心力衰竭的评估及早期诊断提供理论依据。
1 资料与方法
1.1 一般资料
2010年1～10月本院急诊和心内科门诊收入院的心力衰竭(心衰)患者45例，符合中华医学会心血管病分会推荐的心力衰竭患者评定标准，按NYHA心功能分级为Ⅲ～Ⅳ级。其中高血压性心脏病10例，扩张性心脏病11例，缺血性心脏病19例，心脏瓣膜病5例。排除标准：肥厚性心肌病、心包积液、急性心肌梗死、多器官功能衰竭、大量胸腔积液、气胸、肺心病、急慢性肝、肾衰竭、恶性肿瘤、脓毒败血症、完全性左束支传导阻滞 ......
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