目的：探讨慢性心力衰竭(chronic heart failure，CHF)合并慢性肾炎患者尿液中血清B型钠尿肽(B-natriuretic peptide，BNP)水平与心功能的相关性。方法：选取2013年6月至2015年6月在我院接受治疗的慢性心力衰竭患者为观察对象，根据其是否合并慢性肾炎分为CHF组和CHF合并慢性肾炎组。观察两组患者肾功能指标及尿BNP水平，比较两组患者心功能指标的差异，分析肾功能指标、尿BNP与心功能的相关性。结果：CHF合并慢性肾炎组患者尿素氮(blood urea nitrogen，BUN)、血清肌酐(serum creatinine，SCr)和BNP水平明显高于CHF组，而肾小球滤过率(glomerular filtration rate，GFR)水平明显低于CHF组，差异具有统计学意义(P<0.05)；CHF合并慢性肾炎组患者左心房直径(left atrial diameter，LAD)、右心房直径(right atrial diameter，RAD)、左室收缩末内径((left ventricular end systolic diameter，LVESD)和左室舒张末内径(left ventricular end diastolic diameter，LVEDD)水平明显高于CHF组患者，左室射血分数(left ventricular ejection fractions，LVEF)水平明显低于CHF组，差异具有统计学意义(P<0.05)；CHF合并慢性肾炎患者的BUN、SCr、BNP与LAD、RAD、LVESD和LVEDD正相关，与LVEF负相关，GER水平与LAD、RAD、LVESD和LVEDD负相关，与LVEF正相关。结论：慢性心力衰竭合并慢性肾炎患者尿液BNP水平较高，且与患者的心功能指标密切相关，可作为临床监测指标。
Study on the correlation between B-natriuretic peptide level and cardiac function in patients with chronic heart failure complicated with chronic kidney disease
Objective: To investigate the correlation between B-natriuretic peptide (BNP) level and cardiac function in patients with chronic heart failure (CHF) complicated with chronic glomerulonephritis. Methods: Patients with chronic heart failure treated in our hospital from June 2013 to June 2015 were selected as the observation object; according to whether it was complicated with chronic nephritis, the patients were divided into CHF group and CHF combined with chronic nephritis group. The renal function and the level of BNP in urinary were observed in two groups. The differences of cardiac function indexes between the two groups were compared, and the correlations between renal function indexes, urinary BNP and cardiac function were analyzed. Results: The level of blood urea nitrogen (BUN), serum creatinine (SCr) and BNP in patients with chronic glomerulonephritis were significantly higher than those in CHF group, while glomerular filtration rate (GFR) level was significantly lower than that of CHF group, and the difference was statistically significant (P<0.05); the levels of right atrial diameter (RAD), left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD) and left atrial diameter (LAD) were significantly higher than that in the patients with CHF, and the level of LVEF was lower than those in the CHF group, the difference was statistically significant (P<0.05); the level of BUN, SCr, BNP in patients with chronic heart failure combined with chronic nephritis were positive correlated with LAD, RAD, LVESD and LVEDD, and were negative correlated with LVEF, the level of GER was negative correlated with LAD, RAD, LVESD and LVEDD, and was positive correlated with LVEF. Conclusion: The level of urine BNP in patients with chronic heart failure combined with chronic nephritis is high, which is closely related with the heart function index and can be used as a clinical marker.