成人房间隔缺损患者血浆氨基末端脑钠肽前体浓度与肺动脉高压的关系  

Plasma N-terminal pro-brain natriuretic peptide levels are positively correlated with degree of pulmonary arterial pressure in atrial septal defect patients

作　　者：方臻飞[1] 李丽[1] 黄亿源[1] 胡信群[1] 沈向前[1] 唐建军[1] 李江[1] 吕晓玲[1] 赵延恕[1] 周胜华[1] 

机构地区：[1]长沙市中南大学湘雅二医院心内科,410011

出　　处：《中国介入心脏病学杂志》2013年第6期350-353,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的通过检测成人房间隔缺损患者血浆氨基末端脑钠肽前体(NT-proBNP)浓度,研究NT-proBNP与肺动脉高压的(PAH)关系,为临床评价先天性心脏病(CHD)相关性肺动脉高压(PAH)的程度提供参考。方法房间隔缺损患者80例为试验组,依据平均肺动脉压(mPAP)分为正常PAH组、轻度PAH组、中度PAH组及重度PAH组各20例;另选20例健康正常人作为对照组。所有患者均行右心导管检查,测右心房、右心室压力、肺动脉收缩压(sPAP)、mPAP与全肺阻力(PVR)。测定患者术前血浆NT-proBNP浓度,分析其与肺动脉压力的相关性。结果房间隔缺损各PAH组血浆NT-proBNP水平明显高于正常对照组,重度PAH组>中度PAH组>轻度PAH组>正常PAH组>对照组(P<0.01)。mPAP与NT-proBNP水平呈正相关(r=0.889,P=0.000),sPAP与NT-proBNP水平呈正相关(r=0.923,P=0.000),PVR与NT-proBNP水平呈正相关(r=0.835,P=0.000)。血浆NT-proBNP浓度67.53 pg/ml对轻度PAH组有较高的诊断价值;血浆NT-proBNP浓度146.80 pg/ml对中度PAH组、血浆NT-proBNP浓度235.90 pg/ml对重度PAH组有一定的诊断价值。结论房间隔缺损患者血浆NT-proBNP水平随肺动脉压力升高而逐渐增加,可作为评价PAH程度的一项指标。Objective A study was designed to investigate the relation between level of plasma Nterminal pro-brain natriuretic peptitde（ NT-proBNP） with degree of pulmonary artery hypertension（ PAH） in atrial septal defect patients. Methods Eighty patients with atrial septal defect（ ASD） were enrolled in our study who received transcatheter interventional therapy successfully. Randomly recruited 20 healthy people as the control. The ASD patients were divided into four groups according to their mean pulmonary artery pressure. The right atrial pressure,right ventricular pressure,and pulmonary artery pressure were measured during right heart catheterisation before transcathetezer closure. The plasma NT-proBNP concentrations were measured before transcathetezer closure. Results There was significant differences in plasma NT-proBNP level before transcatheter closure among the five groups（ P 0. 01）. The level of Plasma NT-proBNP in decending order was serious PAH moderate PAH mild PAH non-PAH group control group（ P 0. 01）. There was a positive correlation between NT-proBNP levels,MPAP,SPAP,and PVR. A Plasma NT-proBNP level of 67. 53 pg / ml for mild PAH showed sensitivity of 91. 9% and specificity of 94. 5%; 146. 8 pg / ml of Plasma NT-proBNP for moderate PAH with sensitivity of 91. 5%,and specificity of 75. 7%; and 235. 9 pg / ml of Plasma NT-proBNP for serious PAH with sensitivity of 95. 0% and specificity of 75. 0%. Conclusions Plasma NT-proBNP level in atrial septal defect increased with the elevation of pulmonary artery pressure. It reflects the severity of pulmonary hypertension in the ASD patients.

关 键 词：氮末端脑钠肽前体 房间隔缺损 肺动脉高压 

分 类 号：R541.1[医药卫生—心血管疾病]