心力衰竭患者血浆N终端脑钠肽与心功能关系的研究

目的:探讨心力衰竭患者血浆N终端脑钠肽(NT-proBNP)浓度对心功能的评价作用。方法:选择我院门诊及住院心力衰竭患者84例,正常对照组30例。用酶联免疫吸附测定法(ELISA)检测受试者血浆NT-proBNP浓度,超声心动图测定不同心功能组患者左心室射血分数(LVEF)及二尖瓣舒张早期流速峰／二尖瓣舒张晚期流速峰值(E／A)。所得结果进行统计检验,分析心力衰竭患者血浆NT-proBNP浓度与心力衰竭严重程度及LVEF、E／A的相关性,同时比较不同类型左心室功能障碍患者的NT-proBNP浓度。结果:心力衰竭患者血浆NT-proBNP浓度较对照组显著增高,且随着心力衰竭程度的加重而明显增加(P<0．01)。方差分析显示不同类型左心室功能障碍各组间NT-proBNP浓度存在差异性(P<0．05)。相关分析显示,NT-proBNP浓度与INEF、E／A存在显著负相关(r=-0．773,P<0．01;r=-0．659,P<0．01)。结论:NT-proBNP可以客观准确评价心功能,可作为一项临床诊断心力衰竭的实验室指标。

Study on the Relationship Between NT-proBNP and Cardiac Function

Objective:To determine the effects of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP), on cardie function in patients with heart failure. Methods:One hundred and fourteen subjects were selected, including 30 healthy controls and 84 patients with heart failure. The plasma NT-proBNP was determined by enzyme-labeled immunosorbent assay (ELISA).Left ventricular ejection fraction (LVEF), mitral annular early diastolic (E) and late diastolic (A) inflow velocities were measured by modified Simpson's equation with echocardiography. Results:The plasma NT-proBNP concentrations of heart failure patients were significantly higher than those of the normal controls. They also increased with the increased severity of heart failure(P<0.01). NT-proBNP plasma levels were different between types of heart failure(P<0.05). The plasma level of NT-proBNP had significant negative correlation with LVEF and E/A (r=-0.773,P<0.01; r=-0.659, P<0.01). Conclusion: Plasma NT-proBNP is a useful index for the evolution of cardiac function.