慢性心衰患者NT-proBNP、血浆肌钙蛋白I、hsCRP检测的意义  

Clinical significance detecting NT-proBNP,plasma cTnI and hsCRP in patients with chronic heart failure

作　　者：林敏瑜[1] 刘菁[1] 辛福顺[1] 郑伯仁[1] 

机构地区：[1]福建医科大学教学医院福州市第二医院心内科,福建福州350001

出　　处：《心血管康复医学杂志》2012年第4期379-382,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨检测慢性心力衰竭(CHF)患者氨基末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)、高敏C反应蛋白(hsCRP)的诊断、预后意义。方法:83例临床诊断为CHF的患者,根据NYHA心功能级别分为Ⅱ级组(27例),Ⅲ级组(29例),Ⅳ级组(27例),各组又根据NT-proBNP下降是否>30%分为NT-proB-NP下降>30%组和NT-proBNP下降≤30%组,分别在入院时及入院7d后测定患者的左心室射血分数(LVEF),左室舒张末期内径(LVEDd),NT-proBNP、cTnI、hsCRP水平。其中75例随访9～12个月以了解心脏事件发生与NT-proBNP,cTnI,hsCRP关系。结果:随着CHF程度加重,NT-proBNP及cTnI,hsCRP水平均明显升高,LVEDd明显增大,LVEF明显减小(P均<0.01);在心功能Ⅳ级组中,与NT-proBNP下降≤30%比较,NT-proBNP下降>30%患者cTnI,hsCRP水平明显降低(P<0.01)。随访患者入院7d时与未发生心脏事件组比较,发生心脏事件患者cTnI[(0.17±0.03)ng/ml比(0.965±0.24)ng/ml],hsCRP[(1.07±0.05)mg/L比(6.97±0.12)mg/L]、NT-proBNP[(253.54±57.40)pg/ml比(4358.70±543.22)pg/ml]水平明显升高(P<0.01)。结论:氨基末端脑钠肽前体,心肌肌钙蛋白I,高敏C反应蛋白在诊断心衰和评估预后方面有临床意义。Objective：To explore diagnostic and prognostic significance detecting N terminal pro brain natriuretic peptide（NT-proBNP）,cardiac troponin I（cTnI） and high sensitive C-reactive protein（hsCRP） in patients with chronic heart failure（CHF）.Methods：According to New York heart association（NYHA） cardiac classification,a total of 83 CHF patients were divided into NYHA class Ⅱ group（n=27）,NYHA class Ⅲ group（n=29） and NYHA class Ⅳ group（n=27）;according to NT-proBNP decreased 30% or not after treatment,each group was further divided into NT-proBNP decreasing 30% group and NT-proBNP decreasing ≤30% group.Left ventricular ejection fraction（LVEF）,left ventricular end-diastolic dimension（LVEDd）,levels of NT-proBNP,cTnI and hsCRP were measured in all patients at the beginning and 7d after admission.A total of 75 cases were followed up for 9～12 months to study relationship among NT-proBNP,cTnI,hsCRP and incidence of cardiac events.Results： As CHF was more severe,there were significant increase in levels of NT-proBNP,cTnI,hsCRP and LVEDd,and significant decrease in LVEF,P0.01 all;in NYHA class Ⅳ group,compared with NT-proBNP decreasing ≤30% group,there were significant decrease in levels of cTnI and hsCRP in NT-proBNP decreasing 30% group（P0.01）.Compared with no cardiac events group on seventh day after admission,there were significant increase in levels of cTnI [（0.17±0.03） ng ml vs.（0.965±0.24） ng ml],hsCRP [（1.07±0.05） mg L vs.（6.97±0.12） mg L]and NT-proBNP [（253.54±57.40） pg ml vs.（4358.70±543.22） pg ml]in group with cardiac events（P0.01）.Conclusion： NT-proBNP,cTnI and hsCRP possess important significance in diagnosis and evaluation of prognosis of chronic heart failure.

关 键 词：心力衰竭 充血性 利钠肽 脑 肌钙蛋白I C反应蛋白质 

分 类 号：R541.610.9[医药卫生—心血管疾病]