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目的评价不同类型克山病患者血浆B型钠尿肽(BNP)水平的变化及临床意义。方法采用双抗夹心免疫荧光法测定25例慢型克山病患者、22例潜在型克山病患者、20例健康对照者血浆BNP浓度,并行超声心动图测定不同类型患者的心脏结构和功能。比较不同组浓度的差异以及各组水平间的相关性。结果慢型克山病患者血浆BNP水平明显高于潜在型克山病患者及健康对照组(P<0.01),潜在型克山病患者血浆BNP水平明显高于健康对照组(P<0.01);慢型克山病患者左室舒张末内径、左室射血分数、左室短轴缩短率与其他两组比较有显著性差异(P<0.01),而潜在型克山病患者与对健康照组比较无显著性差异;血浆BNP水平与左室舒张末内径呈正相关(r=0.76,P<0.01),与左室射血分数和短轴缩短率均呈负相关(r=-0.50和r=-0.53,P<0.01)。结论不同类型克山病患者血浆BNP水平均明显增高,并与心功能恶化程度呈正相关,BNP水平对克山病患者心功能不全早期诊断和预后评估具有重要意义。
Objective To evaluate the changes of plasma B-type natriuretic peptide (BNP) in patients with different types of Keshan disease and its clinical significance. Methods Plasma BNP levels were measured in 25 patients with chronic Keshan disease, 22 with Keshan disease and 20 healthy controls by double-antibody sandwich immunofluorescence method. The cardiac structure and function of different types of patients were determined by echocardiography. The difference of concentration in different groups and the correlation between different groups were compared. Results Plasma BNP levels in patients with chronic Keshan disease were significantly higher than those in patients with underlying Keshan disease and healthy controls (P <0.01). Plasma BNP levels in patients with underlying Keshan disease were significantly higher than those in healthy controls (P <0.01). Compared with the other two groups, there was significant difference (P <0.01) in left KD, left ventricular ejection fraction, left ventricular fractional shortening in patients with chronic Keshan disease, (R = 0.76, P <0.01), but negatively correlated with left ventricular ejection fraction and short axis shortening (r = -0.50 and r = -0.53, P <0.01). Conclusions Plasma BNP levels were significantly increased in patients with different types of Keshan disease and positively correlated with the worsening of cardiac function. The level of BNP is of great significance for the early diagnosis and prognosis evaluation of patients with Keshan disease.