B型脑钠肽、超敏C-反应蛋白与老年难治性心力衰竭患者心功能的关系

摘要

目的 探讨老年难治性心衰患者B型脑钠肽(BNP)、高敏C反应蛋白(hs-CRP)水平与心功能的关系.方法 对33例老年顽固性心衰患者(心力衰竭组)和15例健康体检者(对照组)检测BNP、hs-CRP水平,同时用彩色多普勒超声心动图仪测定左室射血分数(LVEV)、左室舒张末期内径(LVDD).结果 与对照组比较,心功能Ⅲ级组、Ⅳ级组患者BNP、hs-CRP、LVDD均明显升高,而LVEF明显降低,差异有统计学意义(P<0.05).心功能Ⅳ级组BNP、hs-CRP、LVDD较Ⅲ级组均明显升高,而LVEF明显降低,差异有统计学意义(P<0.05).相关分析示BNP与心功能分级(r=0.769,P<0.05)和LVDD(r=0.725,P<0.05)呈显著正相关,与LVEF(r=-0.876.P<0.05)呈显著负相关;而CRP与心功能分级(r=0.357,P=0.02)呈显著正相关,与LVEF(r=0.202,P=0.078)、LVDD(r=0.374,P=0.072)无明显相关.结论 老年难治性心衰患者BNP和hs-CRP随心力衰竭程度的加重而相应升高,BNP与左心功能状态有良好的相关性,对老年难治性心衰患者的诊断及预后有较好预测价值.%Objective To investigate the relationship between the levels of brain natriuretic peptide (BNP) and high sensitive C-reactive protein (hs-CRP) in the elderly patients with refractory heart failure. Methods The plasma levels of BNP and hs-CRP were tested in 33 elderly patients with refractory heart failure( heart failure group)and 15 healthy volunteers (control group). The left ventriculardiastolic diameter(LVDD) and ejection fraction (EF) were detected by colorDopplerultrasound. Results The levels of hs-CRP, BNP and LVDD of heart failure group were obviously higher than those of control group, while the level of LVEF of patients was obviously lower than that of control group. The levels of hs-CRP, BNP and LVDD of cardiac function NYHA class Ⅳ group were obviously higher than those of NYHA class Ⅲ group, while the level of LVEF of patients was obviously lower than that of NYHA class Ⅲ group. The plasma level of BNP had positive correlations with the severity of NYHA class ( r = 0. 769, P ＜ 0. 05 ), LVEF ( r = - 0. 876, P ＜ 0. 05 ), and LVDD ( r = 0. 725, P ＜ 0. 05).While, the level of hs-CRP had positive correlation with the severity of NY HA class( r = 0. 357, P = 0. 02). Conclusions The levels of hs-CRP and BNP are increased with severity of NYHA class. The level of BNP is related more closely to heart function, which has diagnostic and prognostic value in the elderly patients with refractory heart failure.