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目的探讨老年左室功能不全患者脑利钠肽(BNP)及与血流动力学的相关性。方法收集北京中日友好医院2005年1月至2006年1月住院病例79例,按欧洲心脏协会(NYHA)心功能分级分为两组。左室功能不全组51例,对照组28例,均定量分析检测BNP,测量左室射血分数(LVEF),其中部分心功能Ⅲ～Ⅳ级的患者经锁骨下静脉插管测量中心静脉压(CVP)。结果对照组BNP为(39.32±5.51)ng/L,心功能Ⅱ级组为(265.94±63.13)ng/L,心功能Ⅲ级组为(569.93±109.17)ng/L,CVP为(9.67±1.23)cmH2O(1cmH2O=0.098kPa),心功能Ⅳ组为(2764.33±1020.53)及(19.61±4.57)cmH2O。比较各组间BNP及CVP差异均有显著性意义,LVEF≤50%组与LVEF>50%组比较,BNP及CVP差异均有显著性意义。结论BNP是判断老年左室功能不全的敏感的指标,在严重心衰患者中BNP与CVP呈正相关。
Objective To investigate the relationship between brain natriuretic peptide (BNP) and hemodynamics in elderly patients with left ventricular dysfunction. Methods A total of 79 inpatients from January 2005 to January 2006 in Beijing Sino-Japanese Friendship Hospital were collected and divided into two groups according to NYHA heart function classification. 51 cases of left ventricular dysfunction group and 28 cases of control group were measured quantitative BNP, left ventricular ejection fraction (LVEF), some patients with cardiac function Ⅲ ~ Ⅳ level by subclavian vein catheterization of central venous pressure CVP). Results The BNP level in control group was (39.32 ± 5.51) ng / L, that in cardiac function group Ⅱ was (265.94 ± 63.13) ng / L, that in heart function Ⅲ group was (569.93 ± 109.17) ng / L and that in CVP group was (9.67 ± 1.23 ) cmH2O (1cmH2O = 0.098kPa), and heart function Ⅳ group (2764.33 ± 1020.53) and (19.61 ± 4.57) cmH2O. The differences of BNP and CVP between the groups were significant, the differences of BNP and CVP between LVEF≤50% group and LVEF> 50% group were significant. Conclusions BNP is a sensitive indicator of left ventricular dysfunction in elderly patients. BNP and CVP are positively correlated in patients with severe heart failure.