N末端B型利钠肽原对老年心力衰竭临床应用价值的研究  

Assessment of Clinical Values on N-terminal Pro-brain Natriuretic Peptide in Elder Patients With Heart Failure

作　　者：黄国鹏[1] 安素 

机构地区：[1]重庆医科大学附属第一医院大足医院心内科,重庆市402360

出　　处：《中国循环杂志》2014年第9期698-701,共4页Chinese Circulation Journal

摘　　要：目的：研究老年（〉60岁）心力衰竭患者血清N末端B型利钠肽原（NT-proBNP）的变化情况及NT-proBNP对老年心力衰竭诊断及病情评估的临床应用价值。方法：比较不同纽约心脏病协会（NYHA）心功能分级心力衰竭患者（心力衰竭I-Ⅳ级组及对照组）血清NTproBNP及肌钙蛋白（cTnI）浓度变化;同时比较收缩性心力衰竭者与舒张性心力衰竭者NT-proBNP及浓度变化,研究NT-proBNP与超声心动图指标左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）的相关性。结果：NT-proBNP对照组与心力衰竭I级组比较无统计学差异（P〉0.05）,不同心功能分级各心力衰竭组比较均有统计学差异（P〈0.05）。cTnI对照组、心力衰竭I级组及心力衰竭Ⅱ级组比较无统计学差异（P〉0.05）,心力衰竭Ⅲ级组、心力衰竭Ⅳ级组与其他各组比较均有统计学差异（P〈0.05）。收缩性心力衰竭平均NT-proBNP、LVEDD较高,舒张性心力衰竭平均LVEF较高;老年心力衰竭患者NT-proBNP与LVEF呈负相关（r=-0.687,P〈0.05）;与LVEDD呈正相关（r=0.735,P〈0.05）。结论：NT-proBNP能较好的反映心力衰竭患者心脏结构及功能的变化,在心力衰竭的早期诊断、病情及预后的评估有重要的临床应用价值。Objective： To assess the clinical value of serum N-terminal pro-brain natriuretic peptide （NT-ProBNP） values in elder patients with heart failure （HF）. Methods： According to NYHA classiifcation, a total of 384 HF patients were divided into 4 groups as NYHA I group, n=35, NYHA II group, n=89, NYHA III group, n=163, NYHA IV group, n=97;and Control group, n=69 normal subjects. The NT-ProBNP and troponin （cTn1） levels were examined in systolic HF and diastolic HF patients, the relationship between NT-ProBNP and left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD） were studied. Results： For NT-ProBNP levels, Control group and NYHA I group were similar, P〉0.05; while it was different among each HF groups, P〈0.05. For cTn1 levels, Control group, NYHA I group and NYHA II group were similar, P〉0.05;while NYHA III group and NYHA IV group were different from other groups, P〈0.05. The patients with systolic HF had the higher NT-ProBNP and LVEDD, the patients with diastolic HF had the higher LVEF. In elder HF patients, NT-ProBNP level was negatively related to LVEF （r=-0.687, P〈0.05） and positively correlated to LVEDD （r=0.735, P〈0.05）. Conclusion： NT-ProBNP may better reflect the cardiac structural and functional changes in HF patients, it is important for HF early diagnosis and prognosis in clinical practice.

关 键 词：舒张性心力衰竭 收缩性心力衰竭 N末端B型利钠肽原 肌钙蛋白 左心室射血分数 左心室舒张末期内径 

分 类 号：R541[医药卫生—心血管疾病]