心脏扩大与血浆氨基末端脑纳肽水平的相关性研究  

Relationship between heart enlargement and plasma NT-proBNP level

作　　者：谌承志[1] 刘智勇[1] 何昕[1] 袁旭明[1] 刘景艳[1] 唐艳芳[1] 

机构地区：[1]南华大学附属浏阳医院心内科,湖南浏阳410300

出　　处：《临床心血管病杂志》2013年第2期94-97,共4页Journal of Clinical Cardiology

摘　　要：目的:探讨心室结构改变与血浆氨基末端脑纳肽(NT-proBNP)水平的相关性。方法:将59例患者按心脏超声检查结果分为单纯右室扩大组(20例)、单纯左室扩大组(19例)及双室扩大组(20例),比较3组的NT-proBNP水平及临床参数特点。结果:与单纯左室扩大组及双室扩大组比较,单纯右室扩大组NT-proBNP水平明显降低[(1 277.94±743.94)pg/ml:(2 177.23±1 544.15)pg/ml,P<0.05;(1 277.94±743.94)pg/ml:(4 099.01±1 560.52)pg/ml,P<0.01]。多因素回归分析发现,肺动脉楔压(PCWP)是NT-proBNP≥2 000pg/ml的独立危险因素(OR=1.32,P<0.01);PCWP为12.5mmHg(1mmHg=0.133kPa)时预测NT-proBNP≥2 000pg/ml的最佳灵敏度为86.4%,最佳特异度为75.6%。结论:单纯右室扩大患者NT-proBNP水平明显低于单纯左室扩大及双室扩大者,PCWP是NT-proBNP≥2 000pg/ml的独立危险因素,NT-proBNP水平可能与左心结构及血流动力学改变关系更密切。Objective：To explore the relationship between ventricular structural changes and plasma NT-proB- NP level. Method：Fifty-nine patients were divided into right ventricle enlargement group （n= 20）, left ventricle enlargement group （n=19） and biventricular enlargement group （n= 20） according to the results of echocardiography to compare the plasma NT-proBNP level and clinical parameters. Result： Compared with left ventricle enlargement group and biventricular enlargement group, NT-proBNP in right ventricle enlargement group significantly decreased [（1 277.94±743.94）pg/ml vs （2 177.23±1 544.15）pg/ml, P〈0.05; （1 277.94±743.94）pg/ ml vs （4 099.01 ± 1 560.52）pg/ml, P〈0.01]. Multivariate Logistic regression analysis showed that pulmonary capillary wedge pressure （PCWP） was the independent risk factor when NT-proBNP≥2 000 pg/ml （OR = 1.32, P〈0.01）. The sensitivity and specificity in predicting of NT-proBNP≥2 000 pg/ml were 86.4% and 75.6% when the average PCWP was 12.5 mmHg （1 mmHg= 0. 133 kPa）. Conclusion： Compared with left ventricle enlargement and biventricular enlargement, patients with right ventricle enlargement have the lowest NT-proBNP, and PCWP is significantly associated with NT-proBNP≥2 000 pg/ml. NT-proBNP level may be more closely related to left ventricular structure and hemodynamic changes.

关 键 词：扩张型心肌病 心脏扩大 氨基末端脑纳肽 肺动脉楔压 

分 类 号：R542.2[医药卫生—心血管疾病]