慢性心力衰竭患者中睡眠呼吸暂停与N末端B型利钠肽原和血清淀粉样蛋白A的关系  

Relationship of N-terminal Pro-B Type Natriuretic Peptide and Serum Amyloid A in Patients With Chronic Heart Failure and Sleep Apnea

作　　者：赵智慧[1] 柳志红[1] 罗勤[1] 张健[2] 熊长明 倪新海[1] 张澍[3] 杨跃进[2] 马秀平[1] 

机构地区：[1]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院肺血管病诊治中心,北京市100037 [2]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院心力衰竭诊治中心,北京市100037 [3]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院心律失常诊治中心,北京市100037

出　　处：《中国循环杂志》2009年第6期437-440,共4页Chinese Circulation Journal

基　　金：首都医学发展基金重点项目(20032011)院所青年基金资助课题

摘　　要：目的:本研究旨在了解慢性心力衰竭合并睡眠呼吸暂停与血浆N末端B型利钠肽原(NT-proBNP)、血清淀粉样蛋白A水平的关系。方法:我院慢性心力衰竭患者223例分为3组,即:慢性心力衰竭合并阻塞性睡眠呼吸暂停(OSA)为OSA组(n=77),慢性心力衰竭合并中枢性睡眠呼吸暂停(CSA)为CSA组(n=83),慢性心力衰竭不合并睡眠呼吸暂停为慢性心力衰竭组(n=63)。对3组患者进行睡眠呼吸监测和测定NT-proBNP、血清淀粉样蛋白A。结果:223例患者平均年龄(56.5±12.3)岁,其中160例(71.7%)合并睡眠呼吸暂停。多元回归分析显示NT-proBNP与CSA呈线性回归(P=0.012);血清淀粉样蛋白A与OSA呈线性回归(P=0.021),差异均有统计学意义。心功能Ⅱ级和Ⅲ级患者中,CSA组的NT-proBNP水平显著高于慢性心力衰竭组(P<0.05),差异有统计学意义。结论:慢性心力衰竭合并睡眠呼吸暂停很常见,NT-proBNP水平与慢性心力衰竭合并CSA相关。血清淀粉样蛋白A与慢性心力衰竭合并OSA相关。Objective ：To study the relationship of N-terminal pro-B type natriuretic peptide （NT-proBNP）and serum amyloid A （SAA） in patients with chronic heart failure and sleep apnea（SA）. Methods ： A total of 223 consecutive patients with chronic heart failure treated in our hospital from November 2003 to August 2008 were retrospectively analyzed. There were 83/223 （37.2%） patients suffered from central sleep apnea（ CSA ） and 77/223 （34. 5% ） suffered from obstructive sleep apnea（OSA）. The patients mean age was 56. 5 ± 12. 3 years. Plasma concentrations of NT-proBNP and SAA were measured using enzyme immunoassay, and the grade of heart failure was evaluated by NYHA standard. Results： There were 160 heart failure patients（ 160/223,71.75% ） combined with SA. Multiple regression analysis indicated that plasma NT-proBNP and SAA associated with CSA and OSA in heart failure patients （ P = 0. 012 and P = 0. 021, respectively）. In CAS patients with NYHA 11 and m grade of heart failure, plasma concentration of NT-proBNP was higher than those without CSA（ P 〈0. 05 ）. Conclusion： Plasma NT-proBNP level was associated in heart failure patients combined with CSA, plasma SAA level was associated in heart failure patients combined with OSA.

关 键 词：心力衰竭 睡眠呼吸暂停 N末端B型利钠肽原 血清淀粉样蛋白A 

分 类 号：R541.6[医药卫生—心血管疾病]