射血分数正常的心力衰竭患者全血N-末端脑钠肽前体浓度变化

目的评估射血分数正常的心力衰竭（心衰）患者全血N-末端脑钠肽前体（N—terminalpro—brainnatriureticpeptide，NT—pro—BNP）浓度的变化。方法入选78例心脏病患者分为3组：心功能正常组22例，射血分数正常心衰（heartfailurewithpreservedejectionfrction，HFPEF）组33例，射血分数减低心衰（heartfailurewithreducedejectionfraction．HFREF）组23例。测定患者的全血NT—pro．BNP浓度并进行超声心动图检查。结果HFPEF组患者全血NT．proBNP浓度高于心功能正常组[（1424±996）pg／mL vS．（167±117）pg／mL，P〈0．01]，低于HFREF组[（1424±996）mg／Lvs（5910±2828）mg／L，P〈0．01]，差异有统计学意义。心衰患者全血NT—proBNP浓度与射血分数呈负相关（r=-0．72，P〈0．01），与左心房内径（r=0．34，P〈0．05）、左心室舒张末内径（r=O．61，P〈0．05）及左心室收缩末内径（r=0．62，P〈0．05）、E／A比值（r=0．40，P〈0．05）呈正相关。结论HFPEF患者全血NT—pro—BNP浓度升高．但升高幅度不如HFREF患者明显。

Assessment of blood N-terminal pro-brain natriuretic peptide levels in patients with heart failure with preserved ejection fraction

Objectives To assess the changes of blood N-terminal pro-brain natriuretic peptide （NT-pro-BNP） levels in patients with heart failure with preserved ejection fraction （HFPEF）. Methods Totally 78 patients with cardiovascular diseases were classified into three groups： 22 cases with normal heart function, 33 cases with HFPEF and 23 cases with heart failure with reduced ejection fraction （HFREF）. Blood NT-pro-BNP levels were measured and echocardiograms were performed in all patients. Results Blood NT-pro-BNP levels in patients with HFPEF were significantly higher than those in patients with normal heart function [ （ 1 424±996）pg/mL vs. （ 167±117）pg/mL,P〈0.01 ] and significantly lower than those in patients with HFREF [ （1 424±996）mg/L vs. （5 910±2828）mg/L,P〈0.01 ]. For heart failure patients, blood NT-pro-BNP levels were negatively correlated with ejection fraction （r=-0.72,P〈0.01）, positively correlated with left atrial diameter （r=0.34,P〈0.05）, left end-diastolic ventricular diameter （r=0.61 ,P〈0.05）, left end-systolic ventricular diameter （r=0.62, P〈0.05） and E/A ratio （r=0.40,P〈0.05）. Conclusions Compared with that of HFREF, HFPEF is associated with a less elevated level of NT-pro-BNP.