摘要
【目的】探讨腹型肥胖患者血浆B型钠尿肽（BNP）水平及其对评估慢性心功能不全的影响。【方法】本院内科收治的慢性心功能不全患者158例，根据腰臀比（WHR）分为两组：腹型肥胖组（男性WHR≥0．85或女性WHR≥0．8）62例和非腹型肥胖组（男性WHR〈0．85或女性WHR〈0．8）96例；ELISA法测定血浆BNP浓度；超声心动图测定舒张末期室间隔厚度（IVST）、左室后壁厚度（LVPW）、左室舒张末内径（LVEDd）、舒张早期速度峰值（E）与舒张晚期速度峰值（A）的比值（E／A）和左室射血分数（LVEF）；比较两组血浆BNP水平及超声心动图测量结果、以BNP100pg／mL为切点评估心脏功能时的诊断敏感性；将血浆BNP测定值进行对数转换后，与BMI进行线性回归分析。【结果】腹型肥胖纽中血浆BNP水平（306．88±225．46pg／mL）明显低于非腹型肥胖组[（548．31±353．22）pg／mL，P〈0．051；以BNP100pg／mL为切点，对心脏舒张功能不全的诊断敏感性腹型肥胖组（83．3％）低于非腹型肥胖组（93．1％），对心脏收缩功能不全的诊断敏感性腹型肥胖组（90．0％）低于非腹型肥胖组（97．4％），但降低程度均无显著性差异（P〉0．05）；LogBNP与BMI之间存在负相关（r=-0．276，P〈0．05）。【结论】腹型肥胖会影响血浆BNP水平，BMI与血浆BNP呈负相关，对腹型肥胖患者进行心功能评价时应考虑‘该因素的影响。
[Objective] To explore the level of B-type natriuretic peptide（BNP） and its impact on evaluating chronic ventricular dysfunction in patients with abdominal obesity. [Methods] Totally 158 patients with chronic ventricular dysfunction were enrolled in this study. According to waist/hip ratio（WHR）, patients were divided into abdominal obesity group（male WHR≥0.85 or female WHR≥0.8, n=62） and non-abdominal obesity group （male WHR〈0. 85 or female WHR〈0.8, n =96）. The plasma concentration of BNP was measured by ELISA. Interventricular septum thickness at enddiastole（IVST）, left ventricular posterior wall（LVPW）, left ventricular end-diastolic dimension（LVEDd）, E/A ratio and left ventricular ejection fraction（LVEF） were measured by echocardiography. Concentration of BNP and parameters measured by echocardiography were compared between two groups. Sensitivity of cutoff 100pg/ml of BNP to diagnose ventricular function was also compared. Linear regression analysis was used to investigate the relationship between Log BNP and BMI. [Results] Plasma concentration of BNP in the abdominal obesity group（306.88± 225.46pg/mL） was obviously lower than that in the non-abdominal obesity group（548.31 ± 353.22pg/mL） （ P 〈0. 05）. BNP100pg/mL was set as the cutoff to evaluate ventricular function. Sensitivity of determining diastolic dysfunction in the abdominal obesity group（83.3 % ） was lower than that in the non-abdominal obesity group（93.1% ）. Sensitivity of determining systolic dysfunction in the abdominal obesity group （90.0%） was lower than that in non-abdominal obesity group （97.4%）. Log BNP was reversely correlated with BMI（r= -0. 276, P 〈0. 05）. [Conclusion] Plasma concentration of BNP can be affected by abdominal obesity. BMI is reversely correlated with plasma BNP. The influence of abdominal obesity must be considered as heart function is assessed.
出处
《医学临床研究》
CAS
2011年第4期640-643,共4页
Journal of Clinical Research
关键词
肥胖症
心钠素
心力衰竭
充血性
obesity
atrial natriuretic factor
heart failure,congestive
