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目的探讨血浆脑钠肽(BNP)浓度水平对心力衰竭(HF)诊断及预后判定的作用。方法荧光免疫法测定93例呼吸困难患者血浆BNP浓度。心脏彩超测定心脏左室射血分数(LVEF)。符合Framingham心力衰竭诊断标准患者61例,按美国心功能分级标准(NYHA)进行心功能分级。HF患者根据出院时血浆BNP浓度分为BNP<400pg/ml(A)和BNP≥400pg/ml(B)两组,对两组患者因HF4周内再次住院率进行比较。结果 HF患者血浆BNP浓度(583±189)pg/ml明显高于非HF组(49±8)pg/ml。随着HF的加重其浓度逐渐升高,HF患者血浆BNP浓度与LVEF呈负相关(r=-0.67,P<0.01)。不同原发病患者血浆BNP浓度差异无统计学意义(P>0.05)。出院时血浆BNP浓度≥400pg/ml(B)组4周内再次住院率升高(P<0.05)。结论血浆BNP浓度变化可作为心衰诊断和预后判断的一项临床便捷指标。
Objective To investigate the effect of plasma brain natriuretic peptide (BNP) levels on the diagnosis and prognosis of heart failure (HF). Methods Fluorescence immunoassay was used to determine plasma BNP levels in 93 patients with dyspnea. Cardiac left ventricular ejection fraction (LVEF) was measured by echocardiography. According to Framingham diagnostic criteria of heart failure in 61 patients, according to the American Heart Association grading standards (NYHA) for cardiac function classification. HF patients were divided into BNP concentration <400 pg / ml (A) and BNP ≧ 400 pg / ml (B) according to plasma BNP concentration at discharge. The two groups were compared again for HF4 week rehospitalization rate. Results The plasma BNP level in patients with HF was significantly higher than that in non-HF patients (58 ± 18) pg / ml (49 ± 8) pg / ml. The concentration of BNP in HF patients was negatively correlated with LVEF (r = -0.67, P <0.01). There was no significant difference in plasma BNP concentrations between different primary diseases (P> 0.05). Hospital discharge plasma BNP concentration ≥ 400pg / ml (B) within 4 weeks of re-hospitalization rate increased (P <0.05). Conclusion The changes of plasma BNP concentration may be used as a convenient and convenient index for the diagnosis and prognosis of heart failure.