血浆N末端B型脑钠肽前体联合6分钟步行试验法对慢性心力衰竭的诊断价值观察

目的探讨血浆N末端B型脑钠肽前体(NT-proBNP)与6 min步行试验法(6MWT)联合评估对慢性心力衰竭(CHF)的诊断价值。方法选取2017年1月—2019年1月于本院就诊的CHF患者80例,设为观察组,并选取同期健康体检者50人,设为对照组,并将观察组根据NYHA分级分为Ⅱ、Ⅲ、Ⅳ级,且根据左室舒缩功能分为舒张性心衰、收缩性心衰及混合型心衰。比较观察组与对照组血浆NT-proBNP水平、6MWT距离及心功能指标;并比较舒张、收缩及混合型心衰间NT-proBNP水平、6MWT距离。结果对照组6MWT距离、LVEF、E/A>心功能Ⅱ级患者>心功能Ⅲ级患者>心功能Ⅳ级患者,对照组NT-proBNP水平<心功能Ⅱ级患者<心功能Ⅲ级患者<心功能Ⅳ级患者,差异有统计学意义(P<0.05);舒张性心衰6MWT距离(273.58±53.24)m>收缩性心衰的(235.14±48.33)m>混合型心衰的(219.48±51.62)m,舒张性心衰NT-proBNP水平(1 654.15±547.24)pg/mL<收缩性心衰的(3728.42±719.38)pg/mL<混合型心衰的(4 071.41±849.59)pg/mL,差异有统计学意义(P<0.05)。结论血浆NTproBNP与6 min步行试验法联合对慢性心力衰竭患者诊断具有重要价值,可有效提高心功能分级准确度,并为临床治疗提供更为优质的指导。

Diagnostic value of plasma NT-proBNP combined with 6 min walking test in patients with chronic heart failure

Objective To evaluate the diagnostic value of plasma NT-proBNP and 6 min walking test (6MWT) in chronic heart failure (CHF). Methods From January 2017 to January 2019, 80 patients with CHF in a hospital were selected as a trial group, and 50 healthy persons were selected as a control group. The trial group was divided into three grades (Ⅱ, Ⅲ, Ⅳ) according to NYHA grade, and in addition, the trial group was also divided into a diastolic heart failure sub-group, a systolic heart failure sub-group and a mixed type heart failure sub-group according to the left ventricular diastolic function and systolic function. The plasma NT-proBNP level, 6MWT distance and cardiac function indexes were investigated and compared between the trial group and the control group, and the levels of NT-proBNP and 6MWT were also investigated and compared among the diastolic, systolic and mixed type heart failure sub-groups. Results In the trial group, in the 6MWT distance, LVEF, and E/A, the heart function grade Ⅱ patients>the heart function grade Ⅲ patients>the heart function grade Ⅳ patients. In the trial group, in the NT-proBNP level, the heart function grade Ⅱ patientssystolic heart failure 6MWT distance>mixed type heart failure 6MWT distance . The diastolic heart failure NT-proBNP level (1 654.15±547.24)pg/mL)Conclusion The combination of plasma NT-proBNP and 6MWT are of great value in the diagnosis of patients with chronic heart failure, which can effectively improve the accuracy of cardiac function grade identification and provide a better guidance for clinical treatment.