充血性心力衰竭患者脑利钠肽与左室质量指数相关性研究.doc免费

充血性心力衰竭患者脑利钠肽水平临床检测 及诊断价值 李海滨 刘刚 刘坤申 河北医科大学第一医院，心内科 050031； 【摘要】目的 本文旨在研究脑利钠肽（BNP）的临床检测及其对充血性心力衰竭（CHF）的诊断价值。方法 选择65例CHF患者（心功能Ⅲ～Ⅳ级）及48例正常对照组。采用酶联免疫吸附法（ELISA）测定两组血浆BNP水平；超声心动图测定LVMI。并将CHF患者的BNP水平与左室质量指数（LVMI）作相关性分析。结果CHF患者的BNP水平与LVMI显著高于正常对照组〔（562.4±282.1）pg/ml比﹙184.2±98.6〕pg/ml (P0.001)和（168.26±58.33）g/m2比（112.18±14.50）g/m2(P0.001)〕，BNP水平与LVMI呈显著正相关（r=0.387;P0.01），在CHF组，血浆BNP浓度在不同心功能分级之间也有显著差异（P0.01）。结论 血浆BNP水平对于CHF具有较高的诊断价值。 【主题词】心力衰竭，充血性；利钠肽，脑 The clinical diagnostic value of the level of brain natriuretic peptide in patients with congestive heare failure LI Hai-bin,Liu Gang, LIU Kun-shen The First Hospital of Hebei Medical University,Shijiazhuang 050031,China ABSTRACT：Obective To evaluate the diagnostic value of the level of plasma brain natriuretic peptide (BNP) in patients with congestive heart failure (CHF). Methods 65 cases of CHF and 48 healthy cases were selectd into the study.The plasma concentrations of BNP were measured by enzyme-linked immunosorbent assay (ELISA).LVMI was measured by two-dimentional echocardiography .Results The plasma concentrations of BNP were much higher in CHF patients than those in healthy subjects 〔（562.4±282.1）pg/ml vs ﹙184.2±98.6〕pg/ml；P0.05〕.There were a positive correlations between the level of BNP and LVMI in CHF patients （r=0.387;P0.01）.The sensitivity of 92%,specificity of 93% for BNP in diagnosis of CHF were evaluated according to the of BNP in henlty subjects as the normal high limit.There were significant differences of BNP level among NYHAⅢ～Ⅳ in CHF patients（P0.05）.Conclusion Plasma BNP level may be the more valuable for diagnosis of CHF MeSH：Heartfailure,congestive; natriuretic peptide,brain 脑钠素（brain natriuretic peptide，BNP）是一种心脏神经激素，室心室功能障碍的特异敏感指标，其主要来源是心室〔1〕〔2〕，左心功能不全时，由于容量负荷引起的心室压力改变，心室肌扩张而快速合成，释放入血，可作为心室重构复原的评估指标。国外研究已经证实，BNP在左室功能不全的患者中升高，与左室功能不良的程度呈正相关〔3〕，并与心功能分级以及患者的预后存在相关性〔4〕〔5〕。是心衰诊断的最佳指标。本研究通过测定CHF患者的BNP水平与LVMI及正常人的BNP水平，探讨血浆BNP水平在CHF患者和非CHF患者间的差异性以及CHF患者血浆BNP水平与LVMI的相关性。