N末端B型利钠肽原与慢性心力衰竭患者心功能相关性的临床研究

目的 观察慢性心力衰竭(CHF)患者N末端B型利钠肽原(NT-proBNP)与心功能的相关性.方法 选择80例CHF患者为观察组,另选20例健康人为对照组.观察组采用β受体阻滞剂、血管紧张素转换酶抑制剂小血管紧张素受体拮抗剂等规范治疗,共28 d.比较治疗前后NT-proBNP浓度、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)各指标的变化.结果 ①对照组NT-proBNP为(87±23)ng/L,观察组NYHAⅡ、Ⅲ、Ⅳ级患者(分别为27、40、13例)治疗后NT-proBNP浓度均明显低于治疗前,差异均有统计学意义(1913±707)ng/L比(2657±368) ng/L,(3403±1003) ng/L比(6037±1742 )ng/L,(6429±1348) ng/L比(8324±679) ng/L,均P＜0.01],均高于对照组(均P＜0.01)；②观察组治疗后LVEDD、LVESD和LVEF的水平均较治疗前改善,差异均有统计学意义(49±9)mm比(53±8)mm,(33±9)mm比(39±10)mm,(58±9)％比(53±10)％,均P＜0.01]；③NT-proBNP与LVEDD及LVESD呈正相关(r值分别为0.640、0.694,均P＜0.01),与LVEF呈负相关(r=- 0.652,P＜0.01).结论 NT-proBNP与NYHA心功能分级、LVEDD、LVESD等有良好的相关性,NT-proBNP可用于CHF患者的临床诊断和疗效判定.

Clinical research of the correlation between N-terminal pro-brain natriuretic peptide and cardiac function ofthe patients with chronic heart failure

Objective To observe the correlation between N-terminal pro-brain natriuretic peptide （NT-proBNP） and cardiac function of chronic heart failure（CHF）. Methods Eighty patients of CHF were chosen as the observation group, and were classified according to the NYHA classification standard. Twenty healthy people were chosen as control group. The results of NT-proBNP and echocardiography indexes, such as left ventricular end- diastolic dimension（LVEDD） , left ventricular end systolic diameter （LVESD） , left ventrieular ejection fraction （LVEF） were compared. Results ①In the same grade of NYHA,compared with the baseline of the observation group,the results of NT-proBNP after treatment were much lower grade Ⅱ （1913 ± 707 ）ng/L vs （2657 ± 368）ng/L,grade Ⅲ （3403 ± 1003） ng/L vs （6037 ± 1742） ng/L, grade Ⅳ （6429 ± 1348 ） ng/L vs （ 8324± 679 ） ng/L, all P 〈 0. 01 ] ;②Compared with the baseline of the observation group, the results of indexes of echocardiography including LVEDD, LVESD and LVEF improved after treatment LVEDD （ 49 ± 9 ） mm vs （53 ±8）mm,LVESD（33 ±9）ram vs（39 ± 10） ram, LVEF（58 ±9）% vs（53 ± 10）% ,P 〈0. 01 ] ;③NT-proBNP and LVEDD/LVESD were positively correlated （ r = 0. 640, r = 0. 694, P 〈 0.01 ） , while NT-proBNP and LVEF had negative correlation （r = -0. 652, P 〈 0. 01 ）. Condusions NT-proBNP can be used in clinical diagnosis of CHF. NT-proBNP shows a good correlation to NYHA and echocardiography indexes.