慢性心力衰竭患者6 min 步行试验与血清脑利钠肽水平的临床研究

目的 通过对慢性心力衰竭患者的6 min 步行试验(6MWT) 的距离和血清脑利钠肽(BNP) 水平的观察, 探讨6MWT 和BNP 水平对心力衰竭患者心脏功能评估的临床意义。 方法 测量51 例慢性心力衰竭患者(心衰组) 的6MWT 距离和酶联免疫吸附法检测血清BNP-32 浓度。并以30 例健康成人为对照组。 结果 心衰组的6MWT 距离380.3 ±121.7 m 明显低于对照组546.8 ±128.5 m (P <0.01)。心衰组BNP 水平758.3 ±289.5 ng·L^-1 明显高于对照组109.3 ±37.6 ng·L^-1 (P <0.01)。NYHA 心功能Ⅱ级的6MWT 距离425.0 ±105.8 m 明显低于Ⅲ 级335.6 ±126.1 m (P <0.01)。NYHA Ⅱ级的BNP 水平638.5 ±224.5 ng·L^-1 明显高于Ⅲ 级878.0 ±334.0 ng·L^-1 (P <0.01)。6MWT 距离<300、300 ~374.9、375 ~ 449.9 和<450 m 患者的BNP 水平分别为988.9 ±202.6、768.6 ±217.4、657.5 ±185.0 和506.9 ±198.4 ng·L^-1 (P <0.01);6MWT 的距离与BNP 水平呈负相关(r=-0.752, P <0.01)。 结论 6MWT 和BNP 水平测定对慢性心力衰竭患者的心脏功能评估具有重要临床意义。

Clinical study on the six-minute walk test and serumbrain natriuretic peptide levels in patients with chronic heart failure

AIM: To investigate clinical significance of Six-Minute Walk Test (6MWT) and serum brain natriuretic peptide (BNP) levels in evaluating heart function in patients with chronic heart failure (CHF). METHODS: 51 patients with CHF (CHF group) and 30 healthy subjects served as control group were involved in the trials.The distance walked in six-minute and the serum levels of BNP-32 by enzyme-linked immunosorbent assay method were observed.The differences among 6MWT distance, BNP levels and different NYHA classes were analysed. RESULTS: The 6MWT distances in CHF group and control group were 380.3 ±121.7 and 546.8 ± 128.5 m, respectively (P <0.01).The serum levels of BNP in CHF group and control group were 758.3 ±289.5 and 109.3 ±37.6 ng·L^-1, respectively (P <0.01). The 6MWT distances in NYHA class Ⅱand Ⅲ of CHF patients were 425.0 ±105.8 and 335.6 ±126.1 m, respectively (P <0.01).The BNP levels in NYHA class Ⅱ and Ⅲ of CHF patients were 638.5 ±224.5 and 878.0±334.0 ng·L^-1, respectively (P <0.01).BNP levels in CHF patients of 6MWT distances among below 300, 300-374.9, 375-449.9 and above 450 m was 988.9 ±202.6, 768.6 ±217.4, 657.5 ±185.0 and 506.9 ±198.4 ng·L^-1, respectively (P <0.01).The 6MWT distance was inversely correlated to the BNP level (r=-0.752, P <0.01). CONCLUSION: Not only 6MWT distances but also serum BNP levels have an important clinical value in evaluating heart function of CHF.