血浆NT-proBNP水平对冠心病无症状心脏舒张功能减退的评估  

Is NT-proBNP an predictor for asymptomatic ventricular diastolic dysfunction in patients with coronary artery disease and preserved ejection fraction

作　　者：史力斌[1] 丁文惠[1] 杨颖[1] 张宝娓[1] 霍勇[1] 

机构地区：[1]北京大学第一医院心内科,100034

出　　处：《中国介入心脏病学杂志》2011年第1期29-32,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的评估血浆NT-proBNP水平对于射血分数正常的冠心病患者出现无症状舒张功能减退的预测价值。方法筛选2009年6月至12月期间于北京大学第一医院心内科住院的确诊心肌梗死或经冠状动脉造影证实的冠心病患者,排除左室射血分数减低者(LVEF<50%)及有心力衰竭症状者,入选253例患者,结合常规超声心动图及组织多普勒结果将患者分为心室舒张功能正常组(115例)及心室舒张功能减退组(138例)。对比两组血浆NT-proBNP水平并分析其对心室功能减退的预测价值。结果心室舒张功能减退组NT-proBNP水平高于心室舒张功能正常组(中位数175.4ng/L,范围8.64～5970ng/L比中位数84.7ng/L,范围5.69～3250ng/L,P<0.01),经logistic回归分析,NT-proBNP水平是心室舒张功能减退的独立预测因子(对数转换后,OR=2.78,95%CI1.43～5.40,P<0.01),应用NT-proBNP水平诊断心室舒张功能减退的ROC曲线下面积为0.67(95%CI0.60～0.73,P<0.01),以NT-proBNP>119.15ng/L作为截点时敏感性为64%,特异性为62%。结论血浆NT-proBNP水平升高是射血分数正常的冠心病患者出现无症状心室舒张功能减退的独立预测指标。Objective To verify whether NT-proBNP might detect asymptomatic diastolic dysfunction（LVDD）in coronary artery disesase patients with preserved ejection fraction.Methods A total of 253 patients with coronary artery disease and preserved ejection fraction were enrolled and divided into two groups as normal diastolic function（NDF）group（n=115）and diastolic dysfunction（DD）group（n=139）by routine echocardiography and tissue doppler image.Serum NT-proBNP levels were detected and its prognostic value of LVDD was analized.Results Serum NT-proBNP level was higher in DD group than in NDF group（175.4 ng/L,8.64-5970 ng/L vs.84.7 ng/L,5.69-3250 ng/L,P0.01）.Logistic regression verified NT-proBNP level was an independent factor for LVDD（Log transformation：OR=2.78,95%CI 1.43-5.40,P0.01）.Moreover,NT-proBNP was a predictor for LVDD（AUC=0.67,95%CI 0.60-0.73,P0.01）with a cut-off value of 119.15 ng/L above that the likelihood to show a LVDD is high（sensitivity=64% and specificity=62%）.Conclusion Elevation of serum NT-proBNP levels is an independent factor for LVDD in patients with coronary artery disease and preserved ejection fraction.

关 键 词：氨基末端脑钠肽前体 冠心病 心室功能障碍 超声检查 多普勒 

分 类 号：R544.105[医药卫生—心血管疾病]