心律失常患者Ⅲ型胶原氨基末端肽水平及其与其他临床指标的相关性  

PⅢ NP level in patients with arrhythmia and its correlation with clinical indexes

作　　者：孙向阳[1] 干志红 张皓[1] SUN Xiang-yang; GAN Zhi-hong; ZHANG Hao;(Department of Cardiology, Central Hospital of Dazhou City, Dazhou, Sichuan, 635000, China)

机构地区：[1]四川省达州市中心医院心内科,四川达州635000

出　　处：《心血管康复医学杂志》2018年第5期527-530,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨心律失常患者血清Ⅲ型胶原氨基末端肽(PⅢNP)水平及其与其他临床指标的相关性。方法:选择2014年4月-2017年4月于我科接受治疗的心律失常患者135例为心律失常组;同期入院健康体检者89例为健康对照组。根据NYHA心功能分级,心律失常组被进一步分为I级组(37例)、Ⅱ级组(39例)和Ⅲ～Ⅳ级组(59例)。测定比较各组间血清脑钠肽(BNP)、PⅢNP水平、左室舒张末内径(LVEDd)、左室收缩末内径(LVESd)、LVEF。分析心律失常患者血清PⅢNP水平与BNP、心功能指标的相关性。结果:与健康对照组比较,心律失常组血清BNP [(1132.88±32.84)μg/L比(1984.63±84.61)μg/L]、PⅢNP水平[(26.44±5.89)ng/ml比(52.51±10.85)ng/ml]、LVEDd [(53.38±4.81)mm比(62.12±5.35)mm]和LVESd [(41.23±5.93)mm比(53.19±6.86)mm]均显著升高,LVEF [(49.85±4.57)%比(34.83±4.53)%]显著降低,P均=0.001。随着心功能分级的升高,血清BNP [(1242.68±36.71)μg/L比(1481.83±46.09)μg/L比(1938.39±51.94)μg/L]、PⅢNP水平[(34.36±5.92)ng/ml比(47.81±6.35)ng/ml比(60.94±6.74)ng/ml]显著升高,且I级组<Ⅱ级组<Ⅲ～Ⅳ级组,P均=0.001。Pearson相关分析显示,血清PⅢNP水平与LVEDd、LVESd呈显著正相关(r=0.329,0.463,P=0.043,0.029),与LVEF呈显著负相关(r=-0.351,P=0.036)。结论:心律失常患者发病后血清PⅢNP水平显著升高,与患者心室结构、心功能指标显著相关。Objective：To explore serum level of amino-terminal propepitide of typeⅢ procollagen（PⅢNP）in patients with arrhythmia and its correlation with other clinical indexes.Methods：A total of 135 patients with arrhythmia,who were treated in our department from Apr 2014 to Apr 2017,were selected as arrhythmia group.Another89 healthy subjects undergoing physical examination simultaneously were enrolled as healthy control group.According to NYHA cardiac function classification,arrhythmia group was further divided into class I group（n=37）,classⅡgroup（n=39）and classⅢ～Ⅳgroup（n=59）.Serum levels of BNP and PⅢNP,left ventricular end-diastolic dimension（LVEDd）,left ventricular end-systolic dimension（LVESd）and LVEF were measured and compared among all groups.Correlation among serum PⅢNP,BNP levels and cardiac function indexes were analyzed in these patients.Results：Compared with healthy control group,there were significant rise in serum levels of BNP[（1132.88±32.84）μg/L vs.（1984.63±84.61）μg/L]and PⅢNP [（26.44±5.89）ng/ml vs.（52.51±10.85）ng/ml],LVEDd[（53.38±4.81）mm vs.（62.12±5.35）mm]and LVESd[（41.23±5.93）mm vs.（53.19±6.86）mm],and significant reduction in LVEF[（49.85±4.57）%vs.（34.83±4.53）%]in arrhythmia group,P=0.001 all.Along with cardiac function class rose,there were significant rise in serum levels of BNP [（1242.68±36.71）μg/Lvs.（1481.83±46.09）μg/Lvs.（1938.39±51.94）μg/L]and PⅢNP [（34.36±5.92）ng/ml vs.（47.81±6.35）ng/ml vs.（60.94±6.74）ng/ml],and class I group〈classⅡgroup〈classⅢ～Ⅳgroup,P=0.001 all.Pearson correlation analysis indicated that serum PⅢNP level were significant positively correlated with LVEDd and LVESd（r=0.329,0.463,P=0.043,0.029）,and significant inversely correlated with LVEF（r=-0.351,P=0.036）.Conclusion：The serum PⅢNP level rises in patients with arrhythmia,it is significantly correlated with ventricular structure and cardiac function indexes.

关 键 词：心律失常 胶原Ⅲ型 心内膜心肌纤维化症 

分 类 号：R541.709[医药卫生—心血管疾病]