二尖瓣反流患者N末端B型利钠肽原与超声心动图指标关系的临床研究  

Comparison of plasma NT-proBNP and echocardiographic parameters in Patients with mitral regurgitation

作　　者：刘丹[1] 刘晓阳[2] 

机构地区：[1]大连医科大学附属大连市第三人民医院心内科,116031 [2]大连医科大学附属大连市第三人民医院神经内科,116031

出　　处：《中国医疗前沿》2013年第19期1-3,96,共4页China Healthcare Innovation

摘　　要：目的探讨二尖瓣反流(MR)患者血浆N-末端B型利钠肽原(NT-proBNP)水平与超声心动图指标之间的关系。方法选择孤立性器质性MR患者55例,依据二尖瓣反流程度将受试者分为三组:轻度MR组(n=10)、中度MR组(n=24)、重度MR组(n=21),同时分别测定血浆NT-proBNP浓度及超声心动图指标。根据ROC曲线下面积评价血浆NT-proBNP浓度和超声心动图指标在诊断MPI异常的意义并找出其切点。结果血浆NT-proBNP随着NYHA分级加重而升高。NT-proBNP与MPI存在明显正相关,与以下超声心动图指标:LVEDV、LVESV、LVEDD、LVESD、LAD、SPAP呈正相关,与LVEF、dp/dt呈负相关。以NT-proBNP 603pg/ml为切点值诊断MPI异常的敏感性71.5%,特异性73.2%。结论血浆NT-proBNP与超声心动图指标评价MR有同样的敏感性和特异性,可以联合超声心动图作为评价MR患者的神经激素指标。Objective The study aimed to compare plasma NT-proBNP and echocardiographic parameters in Patients with mitral regurgitation. Methods Total 55 patients with mitral regurgitation were enrolled in this study. Patients were divided into three groups according the severity of MR. Plasma concentration NT-proBNP, 2D and Doppler echocardiography were obtained from 55 patients with organic mild, moderate and severe MR. The areas under the ROC curves were used to evaluate the diagnostic performance of NT-proBNP and echocardiographic variables for the prediction of abnormality of MPI. Results NT-proBNP levels were increased with symptoms in patients with mitral regurgitation. The plasma NT-proBNP level were significantly correlated with MPI, and following echocardiographic indices： LVEDV, LVESV, LVEDD, LVESD, LAD and SPAP, and negative correlation with LVEF, dp/dt. An NT-proBNP serum level of 603pmol/l can show the abnormality of MPI with a sensitivity of 71.5% and a specificity of 73.2%. Conclusion Plasma NT-proBNP level has the same sensitivity and specificity as echocardiographic variables and may be used as a hormonal factor for the evaluation of patients with MR in combination with echocardiography.

关 键 词：二尖瓣反流 利钠肽 脑 超声心动图 

分 类 号：R540.4[医药卫生—心血管疾病]