慢性心力衰竭患者血浆NT-proBNP水平对左室收缩功能障碍的诊断价值

目的探讨N末端前脑钠肽（NT-proBNP）在慢性心力衰竭（CHF）患者血浆中的表现水平,与超声心动图法所测左室射血分数（LVEF）及左室舒张末内径的相关性,进一步明确NT-proBNP对低LVEF的CHF患者的临床指导意义。方法选取LVEF≤0.4,左室舒张末内径〉55mm的CHF患者共34例,测血浆NT-proBNP浓度。根据LVEF数值分为LVEF〈0.3组和LVEF≤0.4组。另根据NYHA心功能分级标准将入组患者分为稳定性CHF组和急性不稳定HF组。结果①LVEF〈0.3组和LVEF≤0.4组间NT-proBNP值无明显统计学差异;②急性不稳定HF组Nt-proBNP水平,显著高于稳定性CHF组;③经相关性分析,NT-proBNP水平与心功能分级呈高度正相关,其与LVEF及左室舒张末内径无显著相关性。结论对于已知存在收缩功能障碍（LVEF≤0.4）的CHF患者,NT-proBNP水平的改变与LVEF无关,而与心衰症状的缓解密切相关。同时可能存在不同程度的基线NT-proBNP水平明显升高。

The role of amino-terminal pro-B-type natriuretic peptide for evaluating the risk stratification in patients with chronic heart failure and low left ventricular ejection fraction

Objective To evaluate the relationship between the level of NT-proBNP and left ventricle ejection frac-tion （LVEF）. Methods All patients enrolled were identified with low LVEF （≤0.4） and LVEDD〉55mm,blood samples were requested to analyze the level of plasma NT-proBNP. Functional capacity was assessed according to the NYHA classification. The subjects were divided into two groups according to the level of LVEF. Results The plasma NT-proBNP level in patients with lower LVEF （≤0.3） did not show statistical significance compared with the low LVEF group.And the correlation with the two facters above was not close. Conclusion In this study,the results of Doppler echocardiogr-aphy and NYHA class may be obviously different in the same patient. Testing of baseline NT-pro-BNP level would assistly estimate for prognosis,risk extent,and the selection of varied treatments.