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目的:探讨慢性心力衰竭患者脑钠肽(BNP)水平与体质量指数(BMI)的关系,明确BNP水平对慢性肥胖心力衰竭患者预后评估的影响。方法:老年充血性心力衰竭患者54例(男性30例,女性24例,左室射血分数<50%),测量患者身高、体重,根据BMI将患者分为3组:对照组(BMI<24 kg.m-2)、超重组(BMI=24～27.9 kg.m-2)及肥胖组(BMI≥28 kg.m-2),通过免疫荧光方法测定患者血浆BNP水平,比较各组血浆BNP水平及BNP水平与BMI的相关性。结果:(1)肥胖组患者血浆BNP水平[(1 460±87)ng.L-1]明显低于对照组[(1 857±145)ng.L-1]及超重组[(1 756±100)ng.L-1](均为P<0.01);(2)BNP与BMI之间存在负相关关系(r=-0.91,P<0.01)。结论:心力衰竭患者血浆中BNP浓度随BMI增加而降低,在应用BNP对心力衰竭患者进行心功能评价时,应同时考虑肥胖因素对其产生的影响。
Objective: To investigate the relationship between BNP level and body mass index (BMI) in patients with chronic heart failure and to determine the effect of BNP level on the prognosis of patients with chronic obesity and heart failure. Methods: 54 elderly patients (30 males and 24 females with left ventricular ejection fraction <50%) were enrolled in this study. The height and weight of the patients were measured. The patients were divided into 3 groups according to BMI: control group (BMI <24 (BMI = 24-27.9 kg.m-2), and obesity group (BMI≥28 kg.m-2). The levels of plasma BNP in the patients were measured by immunofluorescence method. The levels of plasma BNP Correlation between levels and BNP level and BMI. Results: (1) Plasma BNP levels in obese patients were significantly lower than those in control group [(1 460 ± 87) ng.L-1] [(1 857 ± 145) ng.L-1] and overweight group [(1 756 ± 100) ng.L-1] (all P <0.01). (2) There was a negative correlation between BNP and BMI (r = -0.91, P <0.01). Conclusion: BNP concentration in plasma of patients with heart failure decreases with the increase of BMI. When BNP is used to evaluate cardiac function in patients with heart failure, the influence of obesity on them should also be considered.