慢性心力衰竭中医证型与NT-proBNP及心功能指标的相关性分析  

Research on the Relation Between NT-proBNP and Indicators of Cardiac Function and Traditional Chinese Medicine Syndrome of Chronic Heart Failure

作　　者：张蕾[1] 董耀荣[1] 吴美平[1] 

机构地区：[1]上海中医药大学附属市中医医院心病科,上海200071

出　　处：《辽宁中医杂志》2012年第11期2211-2213,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家"十一五"科技支撑计划(2006BAI08B01-04);上海市第三期重点学科(S30302);浦东新区中医药事业发展专项资金项目(PZX2010-1)

摘　　要：目的:从心功能及神经内分泌方面探讨客观指标与慢性心力衰竭中医证型的相关性及中医证型的证候规律。方法:符合Framingham的心衰诊断标准患者300例,进行中医辨证分型,测定NT-proBNP水平;检测心超指标;应用SPSS16.0统计,组间比较用方差分析,采用R×C列量表进行相关性分析。结果:心功能Ⅱ级多为心肺气虚证、气阴两亏证;心功能Ⅲ级、Ⅳ级多为心肾阳虚、气滞血瘀、阳虚水泛证。随NT-proBNP水平增加及EF、FS数值由高到低的顺序,呈现心肺气虚、气阴两亏、心肾阳虚到气虚血瘀或阳虚水泛趋势。结论:心功能分级、NT-proBNP水平、EF、FS等指标与中医证型具有相关关系,在一定程度上可以作为心力衰竭的中医客观化指标。Objective：To probe the relevance between objective indicator and Traditional Chinese Medicine（TCM） syndrome of Chronic Heart Failure（CHF） from the point of heart function and neuroendocrine.Methods：300 cases of CHF according to Framingham Criteria were enclosed and divided into different groups according to TCM syndrome differentiation.And their NT-proBNP levels were measured and Color Ultrasonic Cardiogram combined with Non-invasive Hemodynamic Detector was made respectively.And the relationship between the TCM syndrome and different indicators were analyzed.Results：The patients in the Lung Qi Deficiency Pattern and Deficiency of both Qi and Yin Pattern were primary with HFⅡ;patients in the Yang Deficiency of Heart and Kidney Pattern,Qi Stagnation and Blood Stasis pattern and Edema due to Yang Deficiency patterns were primary with HF Ⅲ and Ⅳ.With the increase of NT-proBNP levels and EF/FS levels,the order was Lung Qi Deficiency PatternDeficiency of both Qi and Yin PatternYang Deficiency of Heart and Kidney PatternQi Stagnation and Blood Stasis pattern or Edema due to Yang Deficiency patterns.Conclusion：The grades of HF and the levels of NT-BNP,EF,FS and IVMI have certain relationship with TCM syndrome differentiation and can be used as objective indicators for TCM syndrome differentiation of heart failure,which facilitate the TCM syndrome differentiation.

关 键 词：慢性心力衰竭 中医证型 NT-PROBNP 心室重构 

分 类 号：R541.6[医药卫生—心血管疾病]