老年维吾尔族慢性心力衰竭患者N末端脑钠肽前体变化

目的探讨N末端脑钠肽前体(NT-proBNP)在老年维吾尔族慢性心力衰竭(心衰)患者中的变化及其临床意义。方法选择老年维吾尔族心衰住院患者130例,按射血分数(LVEF)值分为LVEF正常心衰组(HFNEF)66例和LVEF降低心衰组(HFREF)64例;据NYHA心功能分级分为Ⅱ级组41例、Ⅲ级组47例、Ⅳ级组42例;对照组60例。电化学发光法检测NT-proBNP水平,采用多普勒超声心动图检测超声心动图指标左室舒张末内径(LVEDD)、左房内径(LAD)、LVEF、左心室二尖瓣舒张早期血流峰值(E)和舒张晚期血流峰值(A)比值(E/A)。分析NT-proBNP在各组间水平变化及差异。结果在LVEF分组中,与对照组相比,心衰各组hs-CRP与NT-proBNP均有升高趋势,差异有统计学意义(P<0.01),而LVEDD随着LVEF的减小有扩大的趋势,差异有统计学意义(P<0.05);在NYHA心功能分级中,各组之间随着NYHA心功能分级级别增高,NT-proBNP水平也逐渐增高,差异有统计学意义(P<0.01);NT-proBNP与hs-CRP、LVEDD、LAD、E/A呈正相关,与LVEF呈显著负相关。结论老年维吾尔族患者的NT-proBNP的水平随着心衰程度的增加而升高,并能很好地反映左室功能。

The changes of N-terminal pro-brain natriuretic peptide in Uygur nationality elderly patients with chronic heart failure

Objective To explore the changes of N-terminal pro-brain natriuretic peptide(NT-proBNP) in Uygur nationality elder patients with chronic heart failure(CHF) and their clinical significance.Methods A total of 130 Uygur nationality elderly patients with CHF were divided into 2 groups according to the LVEF(HFNEF≥45%,n= 66;HFREF2<45%,n=64)or the New York Heart Association criteria(NYHAⅡ,n=41;Ⅲ,n=47;Ⅳ,n=42).Sixty Uygur nationality elder patients with cardiovascular disease and without CHF served as controls.Serum NT-proBNP(electrochemiluminescence immunoassay on Elecsys 2010) was examined on the next morning after admission;echocardiography was performed on the third day after admission.LVEDD,LA,LVEF,E/A were measured.The difference and relationship of NT-proBNP level in each group were analyzed between NT-proBNP and the above monitoring indicators.Results In the groups according to the LVEF,the levels of serum hs-CRP and NT-proBNP significantly higher in patients with HFNEF or HFREF those of controls(P<0.01).with the decreasing of LVEF,LVEDD increased(P<0.05);In the groups according to the NYHA functional classes,with the increasing of NYHA functional classes,NT-proBNP levels increased(P<0.01).There were positive correlations between serum NT-proBNP and hs-CRP,LVEDD,LAD,E/A,and negative correlation between serum NT-proBNP and LVEF in CHF group.Conclusion With the increasing of heart destroy,N-terminal pro-brain natriuretic peptide in Uygur nationality elderly patients with CHF increased,and can reflect left ventricular function very well.