组织多普勒成像联合血浆N末端B型钠尿肽原评价左心室舒张功能

目的应用组织多普勒成像技术结合血浆N末端B型钠尿肽原（NT—proBNP）共同评价左心室舒张功能。方法随机选择120例左心室舒张性心力衰竭患者为研究组，120例心功能rF常且无心力衰竭症状和依据的患者为对照组。分别测取患者血浆NT—proBNP水平、左心室射血分数（排除收缩性心力衰竭患者），二尖瓣血流频谱舒张早期速度（E）和二尖瓣血流频谱舒张晚期速度（A）并计算其比值E／A，二尖瓣环室间隔舒张早期峰值速度（Esep）和左心室游离壁舒张早期峰值速度（Elat），两者的均值作为二尖瓣环舒张早期速度（Em），并计算二尖瓣血流频谱舒张早期速度E和二尖瓣环舒张早期速度Em的比值E／Era，综合评价左心室舒张功能。结果研究组与对照组比较，平均血浆NT—proBNP水平增高（P〈0．01），E／Era增大（P〈0．01），E／A减小（P〈0．01）。研究组、对照组患者的平均血浆NT—proBNP水平与E／Era呈正相关。利用E／Em检出左心率舒张性心力衰竭阳性率高于E／A，联合NT—proBNP和E／Em诊断左心室舒张性心力衰竭阳性预测值为94％，阴性预测值为83％。结论血浆NT—proBNP水平与组织多普勒成像左心室舒张功能参数E／Em之间存在明显的相关性，联合NT—proBNP和E／Em较E／A能更好的诊断左心室舒张忡心力衰竭。

Evaluation of left ventricular diastolic function by tissue Doppler imaging and plasma N-terminal pro-brain natriuretic peptide

Objective To assess the left ventricular diastolic function in patients by tissue Doppler imaging and plasma N-terminal pro-brain natriuretic peptide. Methods 120 patients with left veulricular diastolic heart failure, and control group of 120 patients without symptoms or evidences of heart tailure. Get the datas of plamsa NT-proBNP,LVEF,the E wave speed, A wave speed and E/A,the mitral annulus velocity of early diastolic phase Era, then calculate the E/Em to assess the left ventricular diastolic function. Results Compared with control group, the level of NT-proBNP was higher（P 〈 0.01 ）, E/Era was larger（ P 〈 0.01 ）, E/A was reduced（ P 〈 0.01 ）. The level of NT-proBNP was correlated positively with E/Era. The positive predict value and negative predict value of diagnosing left ventricular diastolic disfunction by NT-proBNP and E/Era were 94% and 83%. Conclusion There is a positive correlation between Plasma NT-proBNP and E/Era. By using these two parameters we can diagnose left ventricular diastolic disfunction better.