收缩性心力衰竭患者降钙素原、氨基末端脑钠肽前体水平及超声心动图变化分析  

Analysis of the levels of PCT,NT-proBNP and echocardiography in patients with systolic heart failure

作　　者：李崇耀 张曼 赵鸿斌[1] 袁建才 桑建卫 何志红[1] LI Chongyao;ZHANG Man;ZHAO Hongbin;YUAN Jiancai;SANG Jianwei;HE Zhihong(Department of Emergency,the First Hospital of Shijiazhuang,Hebei Province,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第一医院急诊科

出　　处：《疑难病杂志》2019年第12期1208-1211,1217,共5页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨血清降钙素原、氨基末端脑钠肽在慢性心力衰竭患者中的诊断价值及预后判断价值。方法选择2015年10月-2017年5月石家庄市第一医院急诊科诊断心力衰竭患者160例。采用随机数字表法分为对照组和观察组各80例。2组患者均给予常规强心、利尿等抗心力衰竭治疗,观察组在此基础上加用芪苈强心胶囊1.2 g口服,3次/d;对照组加用安慰剂口服。2组患者均治疗3周后进行疗效评价。全部患者采取空腹静脉血,以免疫化学发光法检测血浆N末端钠尿肽前体(NT-proBNP)、血清降钙素原(PCT)、C反应蛋白(CRP)水平,应用彩色多普勒超声诊断仪进行超声心动图检测,包括左房内径(LAD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、室间隔厚度(IVS)、左室后壁厚度(LVPWT)等指标。并随访观察2组患者预后。结果治疗3周后,2组患者心功能均明显改善,观察组改善较对照组更为明显,差异有统计学意义(χ^2=6.335,P<0.05) 2组患者血清学指标包括PCT、NT-proBNP、CRP水平均显著下降,与治疗前比较差异有统计学意义(P<0.05),且与对照组比较,观察组3项指标下降更为显著(P<0.05)。对照组患者心功能超声检测指标LAD、LVEDD、LVEF均显著改善,差异有统计学意义(P<0.05),而IVS、LVPWT无显著变化(P>0.05);观察组上述各项指标均显著改善,差异均有统计学意义(P <0.05),且观察组均优于对照组(P<0.05)。2组患者均未发生严重不良反应。结论芪苈强心胶囊联合治疗慢性心力衰竭患者疗效显著,血清生化指标和超声心动图指标均显著改善。Objective To explore the diagnostic value and prognostic value of serum procalcitonin and N-terminal pro brain natriuretic peptide(NT-proBNP) in patients with chronic heart failure.Methods From October 2015 to May 2017,160 cases of heart failure were diagnosed in the emergency department of the first hospital of Shijiazhuang.Random number table method was used to divide 80 cases into control group and observation group.2 groups of patients were given conventional cardio diuresis and other anti heart failure treatment,and the observation group was additionally given Qiliqiangxin capsule1.2 g orally,3 times/d.The control group was given placebo orally.The curative effect was evaluated after 3 weeks of treatment in both groups.All patients received fasting venous blood.The levels of plasma N terminal natriuretic peptide precursor(NT-proBNP),serum procalcitonin(PCT) and C reactive protein(CRP) were detected by immunochemiluminescence.Color Doppler echocardiography was used to detect echocardiography,including left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),ventricular septal thickness(IVS) and left.Posterior wall thickness(LVPWT) and other indicators.The prognosis of the two groups was observed.Results After 3 weeks of treatment,the cardiac function of the two groups was improved significantly,and the improvement of the observation group was more obvious than that of the control group,the difference was statistically significant(x^2=6.335,P <0.05).The serum levels of PCT,NT-proBNP and CRP in the two groups decreased significantly compared with those before treatment(P <0.05).Compared with the control group,the 3 indexes in the observation group decreased more significantly(P <0.05).The indexes of LAD,LVEDD and LVEF in the control group were improved significantly(P<0.05),while IVS and LVPWT did not change significantly(P <0.05).The above indexes in the observation group were significantly improved(P <0.05),and the observation group was better than the

关 键 词：心力衰竭 慢性 降钙素原 氨基末端脑钠肽前体 超声心动图 芪苈强心胶囊 

分 类 号：R54[医药卫生—心血管疾病]