The Study Of Influence On Relationship Between B-type Natriuretic Peptide And Platelet Parameters In Patients With Chronic Heart Failure

Objective:To investigate the value of B-type natriuretic peptide(BNP)level in diagnosis of chronic heart failure(CHF),and the relationship between BNP and platelet parameters in patients with CHF.Methods:Sixty-six consecutive patients admitted with CHF diagnosed by two cardiologists based on clinical data,and eighteen patients admitted with cardiac disease without CHF were enrolled randomly.Upon entry the study,patients were measured BNP level by enzyme-linked immunosorbent assay(ELISA).The patients who suffered from hematologic disease,connective tissue disease,malignant tumor, cerebrovascular disease or severe insufficiency of function in liver and kidney were all excluded.Simultaneously,the detailed clinical feature,laboratory index and the result of auxiliary examination were recorded at the time of peripheral blood sampling.Statistic analysis was made to explore the variance of data and the relationship between them by SPSS11.5 Statistic Software.Results:(1)The level of plasma BNP was much higher in CHF patients than that in the controls(median:946.6 pg/ml vs 390.2pg/ml)by applying nonparametric test (Z=-4.317,P=0.000＜0.01).(2)The level of plasma BNP in different degree of cardiac function according to NYHA class were closed to each other.There was no significant statistic differences by nonparametric test(x~2=-6.476,P=0.871＞0.05).(3)In univariate analysis and multifactorial logistic regression analysis,BNP level was the independent and sensitive index for diagnosing CHF.(4)The level of plasma BNP in the CHF patients showed a significant negative correlation with LVEF(r=-0.43,P=0.003＜0.01),and a significant positive correlation with LAD(r=-0.56,P＜0.01),but no relationship was found with LVEDD(r=-0.17, P=0.12＞0.05).(5)The platelet(PLT)count was found no significant differences between two group patients,but the values of P-LCR,MPV and PDW were all obviously elevated in CHF patients compared with the control group(P＜0.01).The level of plasma BNP in the CHF patients showed a good correlation with P-LCR,MPV and PDW(r=0.30, P＜0.05 vs r=-0.22,P＜0.05 vs r=0.28,P＜0.05).Conclusions:(1)The level of plasma BNP could be an auxiliary reference index in the diagnosis of heart failure.(2)Logistic regression analysis indicated that BNP could be a sensitive and independent index in the diagnosis of heart failure.(3)The platelet volume indices were obviously higher in CHF patients,which suggested larger platelets may be more reactive and contributed to vasooclusive events in patients with CHF.(4)The level of plasma BNP in the CHF patients showed a significant positive correlation with P-LCR,which suggested P-LCR may be one of the important indexes to prognose the early hepatocrirrhosis in CHF,and one of indexes in monitoring the efficacy of the treatment in CHF.