|本期目录/Table of Contents|

[1]夏向南,缪海雄.老年心力衰竭患者测定脑利钠肽的 临床意义[J].医学研究与战创伤救治(原医学研究生学报),2008,10(04):271.
　XIA Xiang-nan,MIAO Hai-xiong.The clinical significance of the concentration of brain natriuretic peptide in elderly patients with heart failure[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2008,10(04):271.
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老年心力衰竭患者测定脑利钠肽的 临床意义()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第10卷
期数:
2008年04期
页码:
271
栏目:
出版日期:
2008-07-20

文章信息/Info

Title:
The clinical significance of the concentration of brain natriuretic peptide in elderly patients with heart failure
文章编号:
1672-271X(2008)04-0271-03
作者:
夏向南; 缪海雄
南京军区福州总院干部病房一科，福建福州350025
Author(s):
XIA Xiang-nan; MIAO Hai-xiong
Deparment of Geriatrics，Fuzhou General Hospital of PLA，Fuzhou 350025，Fujian,China
关键词:
老年; 心力衰竭; 脑利钠肽
Keywords:
Aged patients; Heart failure; Brain natriuretic peptide
分类号:
R541.6
DOI:
-
文献标志码:
A
摘要:
目的探讨老年舒张性心力衰竭(DHF)与收缩性心力衰竭(SHF)中脑利钠肽(BNP)的变化及诊断早期DHF的临界值。方法对老年DHF64例患者及34例SHF患者检测BNP，81例无心衰患者作对照。结果①NYHA心功能Ⅱ～Ⅳ级患者BNP水平分别为(281.47±247.60) pg/ml、(1235.60±926.79) pg/ml、(2838.75±1193.80) pg/ml，P=0.001；②BNP水平在SHF和DHF中分别为(746.3±823.0) pg/ml、(2468.9±1288.9),Ｐ=0.000; ③在SHF、DHF，BNP与左心室射血分数均呈负相关，r值分别为－0.595(P=0.001)、－0.333(Ｐ=0.016)；④在SHF，BNP与左心室大小呈正相关(r=0.435，P=0.026)；在DHF，BNP与左心房大小呈正相关，(r=0.359，P=0.01)。⑤排除SHF后，以78.50　pg/ml为临界值诊断DHF的曲线下面积为0.995，其敏感性96.8%，特异性为97.5%。结论BNP能反映心力衰竭的严重程度，可作为诊断早期DHF的有效指标。
Abstract:
ObjectiveTo investigate the differences of BNP level between diastolic heart failure(DHF) and systolic heart failure (SHF) in the aged patients，and to identify the diagnostic threshold value of early DHF.MethodsThe plasma levels of BNP were measured in 64 aged patients with DHF and 34 aged patients with SHF.81 patients with normal heart function were used as control group.Results①The plasma levels of BNP in patients with heart function rated NYHA Class Ⅱ～Ⅳ were 281.47±247.60、1235.60±926.79 and 2838.75±1193.80 (pg/ml) respectively (P=0.001).②The levels of BNP in SHF and DHF were 746.3±823.0 and 2468.9±1288.9 (pg/ml )respectively (P=0.000).③There was a negative correlation between LVEF and BNP in both SHF and DHF(r＝-0.595，P=0.001；r＝-0.333，P=0.016)；④There was a positive correlation between LVD and BNP in SHF(r=0.435，P=0.026)，while in DHF patients, LAD is positively related to BNP(r=0.359，P＝0.001); ⑤Excluding SHF，when 78.50pg/ml used as the threshold value to diagnose DHF，the area under the curve (AUC)was 0.995, the sensibility was 96.8％，and the specificity was 97.5％.ConclusionThe levels of BNP could reflect the severity of heart failure and it was a valuable laboratory marker to diagnose early DHF.

参考文献/References:

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[4］Takeda Y,Fukutomi T,Suzuki S,et al.Effects of carvedilol on Plasma B-Type natriuretic peptide concentration and symptoms in patients with heart failure and preserved ejection Fraction［J］.Am J Cardiol 2004,94:448-453.
[5］Mak GS,Demaria A,Clopton P,et al.Utility of B-natriuretic peptide in the evaluation of left ventricular diastolic function:comparison with tissue Doppler imaging recordings［J］.Am Heart J，2004，148(5):895-902.
[6］Aurigemma GP, Zile MR, Gaasch WH, et al. Lack of relationship between Doppler indices of diastolic function and left ventricular pressure transients in patients with definite diastolic heart failure［J］ . Am Heart J，2004,148(3):e121-e126.
[7］张瑞华. 老年舒张性心力衰竭与收缩性心力衰竭患者左心形态及功能的超声评价［J］. 中国心血管杂志，2002,7(5):345-346.
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备注/Memo

备注/Memo:
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更新日期/Last Update: 2013-11-22