慢性心力衰竭患者血清脑利钠肽水平的变化及其临床意义

中国临床药理学与治疗学 ›› 2003, Vol. 8 ›› Issue (6): 631-634.

慢性心力衰竭患者血清脑利钠肽水平的变化及其临床意义

陈协兴, 洪华山, 王一波, 江琼, 董现锋, 陈良龙

福建医科大学附属协和医院心内科,福建省冠心病研究所,福州 350001,福建

收稿日期:2003-05-22 修回日期:2003-06-12 出版日期:2003-12-26 发布日期:2020-11-19
通讯作者: 洪华山,男,医学博士,副教授,硕士生导师,研究方向:冠心病及其心肌纤维化的临床与基础研究。Tel:0591-3357896-8455 8475 E-mail:honghuashan@hotmail.com
作者简介:陈协兴,男,医学硕士,主治医师,研究方向:心血管病临床研究。

Changes and clinical significance of serum brain natriureticPeptidelevels inPatients with chronic heart failure

CHEN Xie-Xing, HONG Hua-Shan, WANG Yi-Bo, JIANG Qiong, DONG Xian-Feng, CHEN LIang-Long

Department of Cardiology,Union Hospital of Fujian Medical University,Fujian Institute of Coronary Heart Disease,Fuzhou 350001,Fujian,China

Received:2003-05-22 Revised:2003-06-12 Online:2003-12-26 Published:2020-11-19

摘要/Abstract

摘要： 目的探讨慢性心力衰竭(心衰)患者血清脑利钠肽(BNP)水平变化及其临床意义。方法用酶联免疫吸附法(ELISA)检测72 例慢性心衰患者(心衰组)和30 例健康成人(对照组)血清BNP-32 浓度,并动态观察心功能分级(NYHA)Ⅲ级、Ⅳ级患者治疗2 wk 后BNP-32 水平变化。比较不同NYHA 分级与不同病因的BNP水平差异,以及治疗前后的动态变化。结果 (1)心衰组BNP水平858 .7±326 .9 ng·L^-1明显高于对照组109 .3±37 .6 ng·L^-1(P<0 .01)。心衰组和对照组的BNP水平的95%可信区间(CI)分别为781 .9 ~ 935 .5 ng·L^-1和95 .3 ~123 .3 ng·L^-1,相互之间无交叉。(2)血清BNP水平对慢性心衰的诊断界值为120 ng·L-1时,其灵敏度和特异性分别为100%和87%。(3)NYHAⅡ级、Ⅲ级和Ⅳ级的BNP水平分别为638 .5±224 .5 、878 .0±334 .0 和1045 .8±585 .1 ng·L^-1(P<0 .01),BNP水平与NYHA 分级呈正相关(r=0 .818,P<0 .01),与原发病无相关性(P>0 .05)。(4)BNP水平较高的患者预后差,治疗后BNP水平下降者疗效较好,反之疗效差。结论 BNP水平对慢性心衰患者的诊断、病情和治疗效果评估、预后判断具有重要临床意义。

关键词: 药效学, 脑, 利钠肽, 心力衰竭, 诊断, 预后

Abstract: AIM: To investigate the changes and clinical significance of serum brain natriureticPeptide(BNP)levels inPatients with chronic heart failure.METHODS: ELISA method was used to measure the serumlevels of BNP-32 in 72Patients with chronic heart failure(HF group)and 30 healthy subjects served as control group.46Patients with New York Heart Association(NYHA)classⅢ and classⅣ were measured repeatly after 2-weeks treatment.The differences between BNPlevels and different NYHA classes or underlying diseases were analysed.The changes of BNPlevels before and after treatment in the samePatients were also compared.RESULTS:(1)The serumlevels of BNPin HF grouPand control grouPwere 858.7±326.9 and 109.3±37.6 ng·L^-1,and the 95% confidence interval of both grouPwere 781.9 -935.5 and 95.3 -123.3 ng·L^-1,respectively(P<0.01).(2)The sensitivity and specificity of BNPcut-off value of 120 ng·L^-1for diagnosing chronic heart failure were 100% and 87%.(3)BNPlevels in NYHA classⅡ,Ⅲ andⅣ were 638.5±224.5,878.0±334.0 and 1045.8±585.1 ng·L^-1,respectively(P<0.01).Thelevels of BNPincreased markedly with NYHA class hightening(r=0.818,P<0.01).CONCLUSION: Thelevels of BNPare significantly increased,and correlated with the NYHA class,as well as withPrognosis inPatients with HF.After treatment,falling BNPlevels inPatients show good outcomes,whereas elevating BNPlevels inPatients show bad outcomes.Thelevel of BNPhas important value in diagnosis,therapentic efficacy andPrognosis ofPatients with chronic heart failure.

Key words: pharmacodynamics, brain natriureticPeptide, heart failure, diagnosis, prognosis

中图分类号:

R969.4

陈协兴, 洪华山, 王一波, 江琼, 董现锋, 陈良龙. 慢性心力衰竭患者血清脑利钠肽水平的变化及其临床意义[J]. 中国临床药理学与治疗学, 2003, 8(6): 631-634.

CHEN Xie-Xing, HONG Hua-Shan, WANG Yi-Bo, JIANG Qiong, DONG Xian-Feng, CHEN LIang-Long. Changes and clinical significance of serum brain natriureticPeptidelevels inPatients with chronic heart failure[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2003, 8(6): 631-634.

参考文献

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