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目的研究B型利纳肽(B-type natriuretic peptide,BNP)生物学变异是否体现稳定慢性心力衰竭(chronicheart failure,CHF)患者疾病进程。方法比较存在扩张性心肌病(dilated cardiomyopathy,DCM)的稳定CHF患者中BNP和肾素-血管紧张素醛固酮系统(renin-angiotensin-aldosterone system,RAS)因子生物学变量。存在DCM稳定CHF患者80例,测定BNP和RAS因子。结果经梯式多变量分析,血清BNP在基线水平(P=0.005)、存在房颤(P=0.014)、高血浆肾素浓度(plasma renin concentration,PRC)(PRC,P=0.002)是显著性独立优势因子,与高BNP相关。随访2个月,无体重和血压的改变,血细胞比容变化(%)与BNP变化不相关(r=-0.325,P=0.000 7),却与PRC变化相关(r=0.680,P=0.001)。结论 BNP生物学变异与PRC生物学变异显著相关,提示在脑利钠肽系统与RAS系统存在生理学相互作用,导致在DCM患者中发生BNP的生物学变异。
Objective To investigate whether the biological variation of B-type natriuretic peptide (BNP) reflects the progression of disease in patients with stable chronic heart failure (CHF). Methods The biological variables of BNP and renin-angiotensin-aldosterone system (RAS) in patients with stable CHF with dilated cardiomyopathy (DCM) were compared. There were 80 patients with DCM stable CHF, BNP and RAS were measured. Results By stepwise multivariate analysis, serum BNP levels at baseline (P = 0.005) were significantly higher in patients with atrial fibrillation (P = 0.014) and plasma renin concentration (PRC) (PRC, P = 0.002) Independent predominance factor, associated with high BNP. No change in body weight and blood pressure, change in hematocrit (%) was associated with changes in BNP (r = -0.325, P = 0.0007), but not with changes in PRC (r = 0.680, P = 0.001) . Conclusions The biological variation of BNP is significantly associated with the variation of PRC biology, suggesting that there is a physiological interaction between the brain natriuretic peptide system and the RAS system, resulting in the biological variation of BNP in patients with DCM.