心力衰竭患者血浆氨基末端脑钠素前体水平与心功能的相关性  

Clinical Study of Relationship Between N-termina Pro-brain Natriuretic Peptide Level and Ventricular Function in Heart Failure

作　　者：黎志明[1] 朱明辉[1] 李蕾[1] 张强[1] 

机构地区：[1]苏州大学附属张家港医院心内科,江苏张家港215600

出　　处：《苏州大学学报（医学版）》2007年第6期919-921,958,共4页Suzhou University Journal of Medical Science

基　　金：张家港市2007年社会发展指导性计划项目。

摘　　要：目的探讨心力衰竭(简称心衰)患者的血浆氨基末端脑钠素前体(NT-proBNP)水平与心功能的关系。方法选择心衰患者107例作为心衰组,以及同期体检正常20人作为对照组,采用双抗体夹心免疫荧光法检测血浆NT- proBNP水平。采用改良Simpson法测定心衰患者的左心室射血分数(LVEF)。结果心衰组患者的血浆NT-proBNP水平中位数显著高于对照组(分别为972.6 pg/mL和83.5 pg/mL,P<0.001),而且随着心功能分级(NYHA分级)的增加而升高。心功能分级4组之间NT-proBNP浓度差异有统计学意义(P<0.001)。血浆NT-proBNP水平与NYHA心功能分级有显著的相关性(r=0.882,P<0.001),而与LVEF呈负相关(r=-0.751,P<0.001)。多元线性回归分析显示LVEF是预测NT-proBNP水平的最强因子(P<0.001),去除LVEF影响后NYHA心功能分级也是NT-proBNP水平的独立预测因子(P<0.05)。结论血浆NT-proBNP水平与左室功能之间有很好的相关性,血浆NT-proBNP浓度可作为心衰患者心功能检测的有效生化指标。Objective To determine the relationship between N-termina pro-brain natriuretic peptide（NT-proBNP） level and ventricular function in patients with heart failure. Methods The study involved 107 consecutive patients with heart failure and 20 healthy controls.Plasma level of NT-proBNP was measured by a sandwich immunoassay （ELMA）with two kinds of antibodies.Left ventricular ejection fraction（LVEF） was measured by modified Simpson equation with Doppler echocardiography. Results The median NT-proBNP level in patients with heart failure was significantly higher compared with the healthy controls （972.6 pg/ml VS 83.5 pg/ml, P〈0.001 ）. In 107 patients with heart failure, NT-proBNP level increased gradually associated with NYHA heart function classes increased by degrees, the statistical difference of median NT-proBNP levels was significantly among Ⅰ - Ⅳclasses （P〈0.001）. There was correlation between NT-proBNP level and NYHA class （r=0.882, P〈0.001）, and LVEF（r=-0.751, P〈 0.001）. Multiple linear regression analysis showed that the LVEF was an independent predictor of the NT-proBNP level （P〈0.001）. when the NT-proBNP level was excluded, NYHA class appeared as alternative independent predictor （P〈0.05）. Conclusion There is a good correlation between the plasma NT- proBNP leve and left ventricular function. This study supports -the use of the plasma NT-proBNP leve as a biochemical marker of ventricular function in heart failure patients.

关 键 词：氨基末端脑钠素前体 脑钠肽 心力衰竭 超声心动图 

分 类 号：R541.6[医药卫生—心血管疾病] R714.252[医药卫生—内科学]