老年男性心力衰竭患者血红蛋白水平变化与脑钠肽及心功能的关系

目的：探讨老年慢性心力衰竭（CHF）患者血红蛋白（Hb）与脑钠肽（BNP）及心功能的关系。方法：测定人选的99例老年男性CHF患者Hb和血清BNP水平，以超声心动图测量左室射血分数（LVEF）及左室舒张末期内径（LVEDd），评价心功能；按Hb水平分为CHF贫血组和非贫血组，同时选择13例老年健康人作为健康对照组。结果：与正常对照组比较，CHF患者血Hb浓度明显降低，BNP浓度明显升高（P均〈0．01），随着心功能恶化，Hb水平和LVEF则逐渐降低，而BNP水平和LVEDd逐渐升高（P〈0．05～0．01）。与非贫血组比较，贫血组血清BNP水平（294．73±488．300）pg／ml比（841．57±1063．310）pg／ml]和LVEDd（51．58±4．500）mm比（56．33±7．451）mm]明显升高（P％0．01），而LVEF明显降低（61．21±6．747）％比（52．30±11．721）％，P〈0．01]。直线相关分析显示，Hb与BNP水平呈负相关（r=-0．443，P〈0．01）；多因素逐步回归分析显示，BNP水平为CHF患者发生贫血的独立影响因素。结论：老年慢性心力衰竭患者血红蛋白水平的降低和脑钠肽水平的升高参与了心功能不全的病理生理过程，而其高贫血发生率可能使心功能不全程度加重。

Relationship among change of hemoglobin level and B- type natriuretic peptide, cardiac function in aged male patients with chronic heart failure

Objective:To study the relationship among levels of hemoglobin(Hb) and B-type natriuretic peptide(BNP),cardiac function in aged patients with chronic heart failure(CHF).Methods:Levels of Hb and serum BNP were measured in 99 aged male CHF patients.Echocardiography was used to measure left ventricular ejection fraction(LVEF) and left ventricular end-diastolic dimension(LVEDd) and evaluate cardiac function.According to Hb levels,CHF patients were divided into CHF anemia group and CHF non-anemia group,and anoth...