慢性心力衰竭左室重构 左室功能与脑钠肽的相关性

【摘要】  　　目的 探讨慢性心力衰竭患者（CHF）左室重构、左室功能与脑钠肽（BNP）水平的关系。方法 应用荧光免疫法快速测定血浆BNP浓度（CHF组和对照组分别196例、64例），通过心脏彩色超声检测结果，计算左室舒张末内径指数（LVIDdI）、左室重量指数（LVMI）。对比CHF各亚组与对照组BNP水平的不同，应用相关性分析了解CHF组LVIDdI、LVMI及年龄、血压、体重指数（BMI）、左室射血分数（LVEF）等因素与BNP关系。结果 CHF组LVDdI、LVMI、BNP均明显高于对照组，以扩张性心脏病组最高。CHF组LVMI、LVDdI与BNP具有明显的相关性（r=0.615，0.476，P＜0.01）；与LVEF具有明显的负相关（r=-0.649，-0.453，P＜0.01）；LVMI、LVDdI与BMI之间无明显相关性；BNP与EF值负相关（r=-0.602，P＜0.01）。多元逐步回归分析显示仅LVMI、LVIDdI、肌酐（Cr）对BNP有独立的影响（决定系数R2=0.437，P＜0.001）。结论 CHF组BNP水平明显高于对照组，具有更高的LVIDdI 、LVMI值和更低的LVEF值患者BNP水平更高，而年龄、血压、BMI与LVMI、LVIDdI和BNP无明显相关性。

【关键词】  充血性心力衰竭；重构，左心室；B型利钠肽

    Relationship between left ventricular remodeling and function in chronic heart failure and brain natriuretic peptide

    WU Bo，ZHANG Shu-fu.Central Hospital of Yangpu District，Shanghai 200090，China

    ［Abstract］  Objective  To investigate the relationship between left ventricular remodeling and function in chronic heart failure（CHF）patients and brain natriuretic peptide（BNP） level.Methods  The serum BNP concentration of 64 controls and 196 CHF patients were measured quickly by luminoimmunoassay.Left ventricular internal diameter index at end dilate（LVIDdI），left ventricular mass index（LVMI） were calculated according to the results of colored Doppler echocardiography.Compared the difference of BNP levels in different groups in CHF patients，and correlations between BNP levels and LVIDdI，LVMI，ages，blood pressure，body mass index（BMI），left ventricular ejection fraction（LVEF） were assessed by using correlation analysis and the stepwise regression analysis.Results  The values of LVIDdI，LVMI and BNP levels in CHF group were obviously higher than those in control group，and with the highest values in dilated cardiomyopathy group.There was obviously positive correlation with LV

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