高龄射血分数保留心衰患者血NT-proBNP、cTnT、LP(a)的变化及与心功能的关系  

Changes of NT-proBNP,cTnT and LP(a)and relationship between them and heart function in elderly patients with heart failure with preserved ejection fraction

作　　者：高美景[1] 孟文超[1] 王立羽[1] Gao Meijing;Meng Wenchao;Wang Liyu(Department of Geriatrics,Second Hospital of Beijing City,Beijing 100036,China;不详)

机构地区：[1]北京市第二医院老年科,北京100036

出　　处：《中国循证心血管医学杂志》2022年第5期595-597,601,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的分析高龄(≥80岁)合并射血分数保留心衰(HFp EF)患者的血N末端脑钠肽前体(NT-proBNP)、全血肌钙蛋白T(cTnT)、脂蛋白(a)[LP(a)]的变化及与心功能的关系。方法选取2019年1月至2020年8月于北京市第二医院老年科收治的年龄≥80岁,入院诊断HFp EF患者73例为观察组,选取同期门诊就诊的年龄≥80岁,无心衰患者70例为对照组。比较两组患者的血cTnT、LP(a)的变化;观察组进一步根据NYHA分级分为心功能Ⅱ级、Ⅲ级及Ⅳ级,比较血NT-proBNP、cTnT、LP(a)在不同心功能组的变化;分析NT-proBNP、cTnT及LP(a)与HFp EF患者心功能不全的相关性。结果观察组cTnT、LP(a)较对照组升高(P<0.05);NYHA分级Ⅲ级及Ⅳ级的患者NT-proBNP、cTnT及LP(a)均较Ⅱ级的患者升高(P<0.05);NYHA分级Ⅳ级的患者NT-proBNP、cTnT及LP(a)较Ⅲ级升高(P<0.05);NT-proBNP、cTnT及LP(a)的升高与HFp EF的心功能不全程度存在正相关性,差异均有显著统计学意义(P<0.01)。结论高龄HFp EF患者中血cTnT、LP(a)升高,且随着心功能不全加重,cTnT、LP(a)及NT-proBNP均会升高。三种检测指标与高龄HFpEF患者的心功能不全程度存在正相关。Objective To analyze the changes of N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin T(cTnT)and lipoprotein(a)[LP(a)],and the relationship among them and heart function in elderly patients(aged≥80)with heart failure with preserved ejection fraction(HFpEF).Methods Elderly HFpEF patients(aged≥80,n=73)were chosen into observation group,and other elderly patients(aged≥80,n=70)without heart failure(HF)were chosen into control group from Jan.2019 to Aug.2020.The changes of cTnT and LP(a)were compared between 2 groups.The observation group was further divided,according to NYHA classification,into gradeⅡgroup,gradeⅢgroup and gradeⅣgroup,and changes of NT-proBNP,cTnT and LP(a)were compared among these 3 groups.The correlation among NT-proBNP,cTnT,LP(a)and cardiac insufficiency was analyzed in elderly HFpEF patients.Results The levels of cTnT and LP(a)were higher in observation group than those in control group(P<0.05).The levels of NT-proBNP,cTnT and LP(a)were higher in gradeⅢgroup and gradeⅣgroup than those in gradeⅡI group(P<0.05).The levels of NT-proBNP,cTnT and LP(a)were higher in gradeⅣgroup than those in gradeⅢgroup(P<0.05).The increases of NT-proBNP,cTnT and LP(a)were positively correlated to the severity of cardiac insufficiency in HFpEF patients(P≤0.01).Conclusion The levels of cTnT and LP(a)increase in elderly HFpEF patients,and with cardiac insufficiency aggravation,the levels of cTnT,LP(a)and NT-proBNP all will increase.These three indexes are positively correlated to severity of cardiac insufficiency in elderly HFpEF patients.

关 键 词：射血分数保留心衰 N末端脑钠肽前体 肌钙蛋白T 脂蛋白(a) 

分 类 号：R541.61[医药卫生—心血管疾病]