慢性心力衰竭患者血清Hcy与NT-proBNP、左心室结构的相关性  

Correlation between serum Hcy and NT-proBNP,left ventricular structure in patients with chronic heart failure

作　　者：彭琛 李波 荣惠 PENG Chen;LI Bo;RONG Hui(Department of Cardiovascular Medicine,Pingxiang Mining Group Limited General Hospital,Pingxiang 337000,China;Department of Neurology,Pingxiang Mining Group Limited General Hospital,Pingxiang 337000,China)

机构地区：[1]萍乡矿业集团有限责任公司总医院心血管内科,江西萍乡337000 [2]萍乡矿业集团有限责任公司总医院神经内科,江西萍乡337000

出　　处：《中国现代医生》2022年第12期8-11,共4页China Modern Doctor

基　　金：江西省卫生健康委科技计划项目(20202068)。

摘　　要：目的探讨慢性心力衰竭(CHF)患者血清同型半胱氨酸(Hcy)与N端B型脑钠肽前体(NT-proBNP)、左心室结构的相关性。方法选取2018年5月至2021年1月在江西省萍乡市矿业集团总医院接受治疗的CHF患者120例作为观察组,按照纽约心脏病协会(NYHA)分级标准将CHF患者分为不同的亚组,心功能Ⅱ级组40例,心功能Ⅲ级组47例,心功能Ⅳ级组33例,另外选取同期健康体检者120例作为对照组,检测患者的Hcy、NT-proBNP水平及左心室射血分数(LVEF)和左心室后壁厚度(PWT)、左心室舒张末期室间隔厚度(IVST)和左心室舒张末期内径(LVDD)等心功能参数,并进行比较及分析其相关性。结果观察组患者的Hcy、NT-proBNP水平显著高于对照组(P<0.001);两组患者的LVEF、PWT、LVDD、IVST左心室结构功能指标比较,差异有统计学意义(P<0.001);随着心功能分级的升高,血清Hcy、NT-proBNP水平及LVDD呈增高趋势(P<0.001),LVEF呈下降趋势(P<0.05),PWT、IVST比较,差异无统计学意义(P>0.05);经Spearman相关性分析结果显示,Hcy与NT-proBNP、LVDD呈正相关(P<0.05),与LVEF呈负相关(P<0.05),与PWT、IVST无明显相关性(P>0.05)。结论CHF患者的Hcy指标高于健康者,且随着心功能病情的加重而升高,与NT-proBNP、LVDD、LVEF具有较高的相关性,有望成为监测CHF患者病情变化的新指标。Objective To investigate the correlation between serum homocysteine(Hcy)and N-terminal B-type natriuretic peptide(NT-proBNP),left ventricular structure in patients with chronic heart failure(CHF).Methods A total of 120 patients with CHF who received treatment in General Hospital of Pingxiang Mining Group in Jiangxi Province from May 2018 to January 2021 were selected as the observation group.The patients with CHF were divided into cardiac function gradeⅡgroup(n=40),cardiac function gradeⅢgroup(n=47),and cardiac function gradeⅣgroup(n=33)according to New York Heart Association(NYHA)classification criteria.The cardiac function parameters,including Hcy,NT-proBNP levels,left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(PWT),left ventricular end-diastolic interventricular septum thickness(IVST)and left ventricular end-diastolic diameter(LVDD),were measured in all patients.Their correlation was compared and analyzed.Results The levels of Hcy and NT-proBNP in the observation group were significantly higher than those in the control group(P<0.001).There were differences in LVEF,PWT,LVDD,and IVST left ventricular structural function indicators between the two groups(P<0.001).With the increase of cardiac functional classification,the serum Hcy,NT-proBNP levels,and LVDD showed an increasing trend(P<0.001),LVEF showed a decreasing trend(P<0.001).And there was no significant difference in PWT and IVST(P>0.05).Spearman correlation analysis showed that Hcy was positively correlated with NT-proBNP and LVDD(P<0.001),negatively correlated with LVEF(P<0.05),and had no significant correlation with PWT and IVST(P>0.05).Conclusion The Hcy index in patients with CHF is higher than that in healthy subjects,and increases with the aggravation of cardiac function.It has a high correlation with NTproBNP,LVDD,and LVEF,and is expected to be a new index for monitoring the changes of CHF patients.

关 键 词：慢性心力衰竭 HCY NT-PROBNP 左心室结构 相关性分析 

分 类 号：R541[医药卫生—心血管疾病]