老年慢性心力衰竭患者N末端钠尿肽前体和心率变异性与心功能的相关性  

Relation of NT-proBNP level with heart rate variability and cardiac function in elderly patients with chronic heart failure

作　　者：王红[1] 张春霞[1] 阎丽[1] 郝振[1] 

机构地区：[1]天津市第五中心医院老年病科,300450

出　　处：《中华老年心脑血管病杂志》2013年第11期1146-1148,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年慢性心力衰竭(CHF)患者N末端钠尿肽前体(NT-proBNP)水平和心率变异性与心功能的相关性。方法选择82例老年CHF患者(CHF组),按照心功能分级(NYHA)又分为:NYHAⅡ级22例,NYHAⅢ级34例,NYHAⅣ级26例;另选择同期健康体检者60例为对照组。用电化学法测2组NT-proBNP水平,超声心动图测定左心室舒张末内径(LVEDD)和LVEF,用24h动态心电图分析2组的心率变异性时域指标。结果与对照组比较,CHF组的NT-proBNP水平及LVEDD显著升高(P<0.01),随NYHA的增高而逐渐升高(P<0.01),LVEF显著降低(P<0.01)。与对照组比较,CHF组的心率变异性各指标均显著降低(P<0.01),随NYHA的增高而逐渐降低(P<0.01),心率变异性各指标均与NYHA呈负相关(P<0.01)。结论老年CHF患者存在自主神经功能受损和失衡,NT-proBNP水平和心率变异性检测能客观定量地反映老年CHF患者心功能状态。Objective To study the relation of NT-proBNP level with heart rate variability and cardiac function in elderly patients with chronic heart failure （CHF）. Methods Eighty-two elderly CHF patients served as a CHF group and were further divided into NYHA II group （n= 22）, NYHA Illgroup （n=34） and NYHA 1V group （n=26）. Sixty subjects undergoing health check served as a control group. Their serum NT-proBNP levels were measured by electrochemical assay. Their left ventricular end diastolic diameter （LVEDD） and left ventricular ejection fraction （LVEF） were measured by echocardiography. Their heart rate variability indexes （SDNN, SDANN,SDNNI,RMSSD,PNN50） were detected by 24-hour electrocardiography. Results The serum NT-proBNP level was significantly higher and the LVEDD was significantly longer which increased with the elevated NYHA while the LVEF and heart rate variability inexdexes were significantly lower which decreased with the elevated NYHA in CHF group than in control group （P^0. 01）. The heart rate variability indexes were negatively related with the NYHA （P〈 0.01）. Conclusion The function of automatic nerve is impaired and imbalanced in elderly CHF patients. The serum NT-proBNP level and heart rate variability can quantitatively show the cardiac function in elderly CHF patients.

关 键 词：利钠肽 脑 心力衰竭 心率 自主神经系统 超声心动描记术 早期诊断 

分 类 号：R541.6[医药卫生—心血管疾病]