不同射血分数慢性心力衰竭患者踝臂指数与N末端-B型脑钠肽前体和同型半胱氨酸的相关性研究  

Study on the correlation of ABI with NT-proBNP and Hcy in patients with chronic heart failure with different ejection fractions

作　　者：古丽斯亚木·阿布都外力 赵利[1] 依尔夏提·吐合塔苏尼 艾力曼·马合木提[1] Gulisiyamu Abuduwaili;Zhao Li;Yierxiati Tuhetasuni;Ailiman Mahemuti(Department of Heart Failure,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;不详)

机构地区：[1]新疆医科大学第一附属医院心力衰竭科,乌鲁木齐830000 [2]新疆医科大学第一附属医院口腔科,乌鲁木齐830000

出　　处：《中国临床保健杂志》2020年第5期636-639,共4页Chinese Journal of Clinical Healthcare

基　　金：2019年度省部共建国家重点实验室中亚高发病成因与防治国家重点实验室开放课题基金项目(SKL-HIDCA-2019-18)。

摘　　要：目的探讨不同射血分数慢性心力衰竭(CHF)患者踝臂指数(ABI)与N末端B型脑钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)的相关性。方法选取2017年1月至2018年10月明确诊断为CHF的患者共405例。根据其左心室射血分数(LVEF)分为射血分数降低的心力衰竭(HFrEF)组、射血分数中间值的心力衰竭(HFmrEF)组和射血分数保留的心力衰竭(HFpEF)组。比较各组患者的ABI、NT-proBNP、Hcy的差异,分析不同射血分数CHF患者的ABI与NT-proBNP、Hcy的相关性。结果与HFrEF组和HFmrEF组患者相比,HFpEF组患者年龄更大,女性比例更高,高密度脂蛋白胆固醇(HDL-C)水平更高,吸烟史比例较低,差异有统计学意义(P<0.05);与HFrEF组患者相比,HFmrEF组患者年龄较大、收缩压水平较高,差异有统计学意义(P<0.05)。HFrEF组ABI明显低于HFmrEF组和HFpEF组,而NT-proBNP和Hcy水平显著高于HFmrEF组和HFpEF组,差异有统计学意义(P<0.05);HFmrEF组ABI明显低于HFpEF组,而NT-proBNP和Hcy水平显著高于HFpEF组,差异有统计学意义(P<0.05)。Pearson相关性分析结果表明,在HFrEF组、HFmrEF组和HFpEF组中,ABI与NT-proBNP、Hcy均呈负相关关系(P<0.05)。多元线性回归分析表明,NT-proBNP、Hcy是ABI的独立危险因素(P<0.05)。结论HFrEF患者ABI最低,三组心力衰竭患者随着NT-ProBNP和Hcy水平的增高,ABI明显下降。Objective To explore the correlation between Ankle brachial index(ABI)and serum N-terminal B-type natriuretic peptide(NT-proBNP)and homocysteine(Hcy)in patients with chronic heart failure(CHF)with different ejection fraction.Methods A total of 405 patients with CHF diagnosed from January 2017 to October 2018 were enrolled.According to left ventricular ejection fraction(LVEF),the patients were divided into three groups:heart failure with reduced ejection fraction(HFrEF),heart failure with mid-range ejection fraction(HFmrEF)and heart failure with preserved ejection fraction(HFpEF).The differences of ABI,NT-proBNP and Hcy in each group were compared,and the correlation between ABI with NT-proBNP and Hcy was analyzed.Results Compared with the HFrEF group and the HFmrEF group,the patients in the HFpEF group were older with a higher proportion of women,higher high-density lipoprotein cholesterol(HDL-C)levels and a lower proportion of smoking history,and the difference was statistically significant(P<0.05).Compared with the HFrEF group,the patients in the HFmrEF group were older and had higher systolic blood pressure levels(P<0.05).The ABI in the HFrEF group was significantly lower than that in the HFmrEF and HFpEF groups,while the levels of NT-proBNP and Hcy were significantly higher than those in the HFmrEF and HFpEF groups.The difference was statistically significant(P<0.05).The ABI in the HFmrEF group was significantly lower than that in the HFpEF group,and NT-proBNP and Hcy levels were significantly higher than those in the HFpEF group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that in the HFrEF,HFmrEF and HFpEF groups,ABI was negatively correlated with NT-proBNP and Hcy(P<0.05).Multiple linear regression analysis showed that serum NT-proBNP and Hcy levels were independent risk factors for ABI(P<0.05).Conclusion Patients with HFrEF have the lowest ABI.With the increasing of NT-ProBNP and serum Hcy levels,ABI is decreasing significantly.

关 键 词：心力衰竭 每搏输出量 动脉硬化 利钠肽 脑 半胱氨酸 

分 类 号：R54[医药卫生—心血管疾病]