慢性心力衰竭患者左室射血分数和B型利钠肽与中医证型的相关性研究

目的探讨慢性心力衰竭(CHF)患者心功能指标左室射血分数(LVEF)、B型利钠肽(BNP)与中医证型之间的相关性。方法收集不同基础病因所致的CHF患者134例,根据美国纽约心脏病协会分级标准和中医辨证分型进行分组,并用放射免疫法测定血浆BNP水平,以惠普多普勒超声测定LVEF,采用SPSS11.5统计软件,分析其间的相关性。结果随着CHF证型的转变(痰饮阻肺证→气阴两虚、血瘀水停证→气阳两虚、血瘀水停证),NYHA级别和BNP逐渐升高,LVEF则相应降低(P0.05,P0.01)。结论 CHF患者心功能指标LVEF、BNP与中医证型之间有一定的相关性,可作为中医临床辨证时的客观量化参考。

Study on the Relationship among LVEF, BNP and TCM Syndrome of Patients with Chronic Heart Failure

Objective To probe the clinical significance of the heart function index （EF, BNP） in patientswith chronic heart failure （CHF） of different pattern of TCM syndromes. Methods One hundred andthirty-four cases confirmed to be CHF, who had different etiopathogenisises, were divided into threegroups according to NYHA classification standard and TCM syndrome differentiation. BNP was determinedby radioimmunoassy and LVEF was detected by Doppler ultrasound. The relationship among LVEF, BNPand TCM syndromes was analyed by SPSS11.5 software. Results When the pattern of syndromes changed（phlegmatic fluid obstructing lung → deficiency syndrome of both qi and yin and syndrome of blood stasisand stagnant water → deficiency syndrome of both qi and yang and syndrome of blood stasis and stagnantwater）, NYHA classify and BNP value showed gradually raising trend, and LVEF showed gradually fallingtrend （P 〈0.05 or 0.01）. Conclusions The pattern of syndromes are correlated with the heart function index（LVEF, BNP） in CHF patients. The changes of above indexes contribute to districting different syndromedifferentiation classifications.