氨基末端脑钠肽前体在慢性心力衰竭中的应用

目的探讨氨基末端脑钠肽前体（NT-proBNP）在慢性心衰中的水平变化及意义。方法选取276例慢性心衰患者为CHF组，根据NYHA分级标准分为心功能Ⅱ级组（80例）、Ⅲ级组（91例）、Ⅳ级组（105例），随机抽取84例健康体检者为对照组；采用电化学发光法测定血清NT-proBNP水平，采用彩色多普勒超声进行左室射血分数（LVEF）功能测定．并进行相关性分析。结果①CHF组治疗前血清NT-proBNP水平显著高于对照组，两组间比较差异具有统计学意义（P〈0．01）；CHF组中随心功能下降，患者血清NT-proBNP水平逐渐升高，心功能Ⅱ、Ⅲ、Ⅳ级组组间比较，差异具有统计学意义（P〈0．01）；②慢性心衰控制组血清NT-proBNP水平明显低于治疗前，二者比较差异具有统计学意义（P〈0．01）；③血清NT-proBNP与LVEF呈负相关。结论NT-proBNP水平变化对慢性心衰的诊断、病情评价、预后判断具有重要的临床价值。

Application of N-terminal pro-brain natriuretic peptide in chronic heart failure

Objective To investigate the N-terminal pro-brain natriuretic peptide （NT-proBNP） and the significance of the changes of level in chronic heart failure. Methods 276 patients with chronic heart failure patients as CHF group, accord- ing to the NYHA grading standards were divided into heart function Ⅱ （80 cases）, Ⅲ （91 cases）, typeⅣ （105 cases） group, randomly selected 84 healthy people as control group. Electrochemical measurement of serum NT-proBNP level luminescence method, using color Doppler ultrasound left ventricular ejection fraction （LVEF） function was measured, and the correlation analysis. Results ①The level of serum NT-proBNP in CHF group was significantly higher than that of the control group treatment, the difference between two groups was statistically significant （P〈0.01）, heart function in group CHF decreased the level of serum NT-proBNP increased gradually, the heart function Ⅱ, Ⅲ, Ⅳgroup the difference between two groups has statis- tical significance （P〈0.01）. ②The control group of chronic heart failure and serum NT-proBNP levels were significantly lower than those before treatment, the two comparison difference had statistics significance （P〈0.01）.③The negative correlation was between serum NT-proBNP and LVEF. Conclusion The change of NT-proBNP level in diagnosis of chronic heart failure, diagnosis, prognosis has important clinical significance.