血浆N端脑钠肽前体与老年慢性心力衰竭患者心功能的关系及其临床意义  

Relationship and clinical significance between N-terminal pro-brain natriuretic peptide level and cardiac function in elderly patients with chronic heart failure

作　　者：葛正中[1] 吴永华[1] 王晓周[1] 

机构地区：[1]南京医科大学附属苏州市立医院本部老年心血管科,江苏省苏州市215002

出　　处：《实用老年医学》2010年第6期463-465,共3页Practical Geriatrics

摘　　要：目的探讨老年慢性心力衰竭(CHF)患者N端脑钠肽前体(NT-proBNP)与纽约心脏病协会(NY-HA)心功能分级,左室结构和功能的关系及其临床意义。方法 110例老年CHF患者,按照NYHA分级方法分为心功能Ⅱ、Ⅲ、Ⅵ级3组,21例健康老年人(心功能Ⅰ级)纳入对照组。电化学发光双抗体免疫夹心法测定4组血浆NT-proBNP水平;超声心动图测定左室结构和功能。结果老年心衰组患者血浆NT-proBNP水平高于健康对照组(P<0.01),且随NYHA心功能分级的增高而逐渐升高(P<0.01),NT-proBNP水平在心功能Ⅲ级与Ⅵ级2组间存在一定的重叠。老年人NT-proBNP水平与左室射血分数(LVEF)呈负相关(P<0.01),与左室质量指数(LVMI)呈正相关(P<0.05)。结论血浆NT-proBNP水平能客观定量地反映老年CHF患者心功能状态,也是对患者进行危险分层的一个有价值的工具。Objective To investigate the relationship between N-terminal pro-brain natriuretic peptide（NT-proBNP）and NYHA classification,left ventricular structure and function in elderly patients with chronic heart failure and its clinical significance.Methods 110 elderly patients with CHF were divided into 3 groups according to cardiac functional classification and 21 healthy elderly subjects were enrolled in control group.The plasma level of NT-proBNP was measured by electrochemiluminescence immunoassay method in the four groups,and the structure and function of left ventricle were examined by echocardiography.Results The plasma level of NT-proBNP increased significantly in elderly patients with CHF compared with healthy controls（P0.01）,and increased progressively in proportion to the degree of NYHA.NT-proBNP levels were negatively correlated with LVEF（P0.01）and positively correlated with LVMI（P0.05）.Conclusions The plasma level of NT-proBNP is a reliable indicator for cardiac function and a useful tool for risk stratification in elderly patients with CHF.

关 键 词：N端脑钠肽前体 心力衰竭 心功能 老年人 

分 类 号：R541.6[医药卫生—心血管疾病]