顽固性心力衰竭患者NT-proBNP与肺超声B线、下腔静脉变异度、左室射血分数、APACHEⅡ评分的相关性分析  

Correlation analysis of NT-proBNP with pulmonary ultrasound B line,inferior vena cava variability,left ventricular ejection fraction and APACHEⅡscore in patients with refractory heart failure

作　　者：卢敏[1] 杨继俊 罗水光 卢妍欣 曾金华[4] 李映笑 马渤键 陈正运 LU Min;YANG Jijun;LUO Shuiguang;LU Yanxin;ZENG Jinhua;LI Yingxiao;MA Bojian;CHEN Zhengyun(Cardiology Department,Dongguan Huangjiang Hospital,Dongguan 523750;Clinical Laboratory Department,Dongguan Huangjiang Hospital,Dongguan 523750;Ultrasound Department,Guangzhou Liwan Matemal and Child Health Hospital,Guangzhou 510375;Critical Care Medicine Department,Dongguan Huangjiang Hospital,Dongguan 523750,China)

机构地区：[1]东莞市黄江医院心内科,广东东莞523750 [2]东莞市黄江医院检验科,广东东莞523750 [3]广州市荔湾区妇幼保健院超声科,广东广州510375 [4]东莞市黄江医院重症医学科,广东东莞523750

出　　处：《临床医学研究与实践》2025年第5期41-44,共4页Clinical Research and Practice

基　　金：2022年东莞市社会发展科技项目(No.20221800900372)。

摘　　要：目的分析顽固性心力衰竭患者N-末端脑钠肽前体(NT-proBNP)与肺超声B线、下腔静脉变异度(IVCV)、左室射血分数(LVEF)和急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分的相关性。方法选择2022年1月至2024年1月住院的109例美国纽约心脏病学会(NYHA)心功能分级Ⅲ级以上的心力衰竭患者作为研究对象,根据顽固性心力衰竭纳入标准将患者分为普通心力衰竭组(简称普通组,87例)和顽固性心力衰竭组(简称顽固组,22例)。两组患者均进行血清NT-proBNP检测、APACHEⅡ评分,同时采用床旁超声进行肺超声B线评分、IVCV及LVEF测量,并进行比较;采用直线相关分析探讨NT-proBNP与肺超声B线评分、IVCV、LVEF和APACHEⅡ评分的相关性。结果顽固组的血清NT-proBNP水平、肺超声B线评分及APACHEⅡ评分均高于普通组,LVEF低于普通组(P<0.05);两组的IVCV无显著差异(P>0.05)。相关性分析结果显示,NT-proBNP与肺超声B线评分、APACHEⅡ评分呈正相关,与LVEF呈负相关(P<0.05);NT-proBNP与IVCV无相关性(P>0.05)。结论顽固性心力衰竭患者的NT-proBNP与肺超声B线评分和APACHEⅡ评分呈正相关,与LVEF呈负相关,与IVCV无相关性。Objective To analyze the correlation between N-terminal pro-B-type natriuretic peptide(NT-proBNP)and pulmonary ultrasound B line,inferior vena cava variability(IVCV),left ventricular ejection fraction(LVEF)and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score in patients with refractory heart failure.Methods A total of 109 patients with heart failure who were hospitalized from January 2022 to January 2024 in the New York Heart Association(NYHA)heart function classⅢor above were selected as the study subjects.According to the inclusion criteria of refractory heart failure,the patients were divided into ordinary heart failure group(abbreviated as ordinary group,87 cases)and refractory heart failure group(abbreviated as refractory group,22 cases).Serum NT-proBNP and APACHEⅡscore were detected in both groups.At the same time,pulmonary B-line score,IVCV and LVEF were measured by bedside ultrasound,and the results were compared.Linear correlation analysis was used to investigate the correlation between NT-proBNP and pulmonary B-line score,IVCV,LVEF and APACHEⅡscore.Results The serum NT-proBNP level,pulmonary ultrasound B-line score and APACHEⅡscore of the refractory group were higher than those of the ordinary group,and LVEF was lower than that of the ordinary group(P<0.05);there was no significant difference in IVCV between the two groups(P>0.05).Correlation analysis results showed that NT-proBNP was positively correlated with pulmonary B-line score and APACHEⅡscore,and negatively correlated with LVEF(P<0.05);there was no correlation between NT-proBNP and IVCV(P>0.05).Conclusion NT-proBNP in patients with refractory heart failure was positively correlated with pulmonary B-line score and APACHEⅡscore,negatively correlated with LVEF,and not correlated with IVCV.

关 键 词：顽固性心力衰竭 N-末端脑钠肽前体 肺超声B线 

分 类 号：R540.4[医药卫生—心血管疾病]