不同类型慢性心力衰竭患者血清肌钙蛋白T和N末端B型钠尿肽原水平变化及临床意义  

Changes and clinical significance of serum TnT and NT-proBNP levels in patients with different types of CHF

作　　者：申文文 延欢欢 SHEN Wenwen;YAN Huanhuan(Department of Laboratory Medicine,Central Hospital of Tongchuan Mining Bureau,Tongchuan 727000,China)

机构地区：[1]铜川矿务局中心医院检验科,陕西铜川727000 [2]铜川市人民医院检验科,陕西铜川727000

出　　处：《陕西医学杂志》2021年第9期1109-1113,共5页Shaanxi Medical Journal

基　　金：陕西省科技计划项目(2020SF-192)。

摘　　要：目的:分析不同类型慢性心力衰竭(CHF)患者血清肌钙蛋白T(TnT)、N末端B型钠尿肽原(NT-proBNP)水平变化及临床意义。方法:将208例CHF患者根据左心室射血分数(LVEF)分为HFREF组[射血分数降低型(LVEF<40%)心力衰竭,79例]、HFMREF组[射血分数中间范围型(40%≤LVEF<50%)心力衰竭,57例]与HFPEF组[射血分数保留型(LVEF≥50%)心力衰竭,72例]。比较三组患者血清TnT、NT-proBNP水平。采用Spearman法分析CHF患者血清TnT、NT-proBNP水平与LVEF相关性。比较不同类型心力衰竭患者随访3个月内心血管不良事件发生情况,并以发生与否作为预后评估标准将其分为预后良好组及预后不良组,比较其血清TnT、NT-proBNP水平。分析不同类型心力衰竭患者血清TnT、NT-proBNP水平与预后的关系。结果:不同类型CHF患者血清TnT、NT-proBNP水平比较,差异有统计学意义(均P<0.05)。血清TnT、NT-proBNP水平与CHF患者LVEF均呈明显负相关(均P<0.05)。HFMREF组及HFPEF组心血管不良事件总发生率低于HFREF组(均P<0.05)。不同类型CHF患者预后良好组与预后不良组血清TnT、NT-proBNP水平比较,差异有统计学意义(均P<0.05)。HFREF患者预后与血清TnT、NT-proBNP水平呈明显正相关(均P<0.05),HFMREF及HFPEF患者预后与血清TnT、NT-proBNP水平无相关性(均P>0.05)。结论:CHF患者血清TnT、NT-proBNP水平上升并与LVEF呈负相关,可作为射血分数降低型心力衰竭患者预后的评估指标。Objective:To analyze the changes and clinical significance of serum troponin T(TnT)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels in patients with different types of chronic heart failure(CHF).Methods:According to the left ventricular ejection fraction(LVEF),208 patients with chronic heart failure(CHF)were divided into HFREF group[heart failure with reduced ejection fraction(LVEF<40%),79 cases],HFMREF group[heart failure with middle reduced ejection fraction(40%≤LVEF<50%),57 cases]and HFPEF group[heart failure with preserved ejection fraction(LVEF≥50%),72 cases].The levels of serum TnT and NT-proBNP were compared among the three groups.Spearman correlation analysis was used to analyze the correlation between levels of serum TnT,NT-proBNP and LVEF in patients with CHF.The occurrence of adverse cardiovascular events were compared among patients with different types of CHF within 3 months of follow-up,and the patients were divided into good prognosis group and poor prognosis group based on whether adverse cardiovascular events occurred or not,and the levels of serum TnT and NT-proBNP were compared.Spearman correlation analysis was used to analyze the relationship between levels of serum TnT,NT-proBNP and prognosis in patients with different types of CHF.Results:The differences in comparison of serum TnT and NT-proBNP levels were statistically significant among patients with different types of CHF(all P<0.05).Spearman correlation analysis showed that the levels of serum TnT and NT-proBNP were significantly negatively correlated with LVEF in patients with CHF(all P<0.05).The incidence rate of adverse cardiovascular events in HFMREF group and HFPEF group was significantly lower than that of HFREF group(all P<0.05).There were statistically significant differences in the levels of serum TnT and NT-proBNP between good prognosis group and poor prognosis group of patients with different types of CHF(all P<0.05).Spearman correlation analysis showed that the prognosis of patients with HFREF was significant

关 键 词：慢性心力衰竭 肌钙蛋白T N末端B型钠尿肽原 临床意义 相关性 射血分数 

分 类 号：R541.61[医药卫生—心血管疾病]