Tei指数结合BNP评价冠心病经皮冠状动脉内支架安装术后患者心功能的对比研究

目的研究冠心病经皮冠脉内支架安装术后患者不同级别心功能Tei指数和NT-ProBNP的变化及其相关性。方法按NYHA心功能分级方法将入选者分为4组,选择冠脉造影提示冠脉病变达50%～70%无须植入支架的且心功能I级的患者为对照组,心功能Ⅱ级者为A组,Ⅲ级者为B组,IV级者为C组,每组40例,A、B、C组均为经冠脉造影证实至少一支主要冠状动脉狭窄〉70%并行冠脉内支架安装术后的冠心病患者,超声心动图测定左室射血分数（LVEF）,左房室瓣口舒张早期与舒张晚期血流峰值速度比值（E/A）、Tei指数;同期取血检测BNP浓度。结果随着心功能级别的升高Tei指数与BNP逐渐增加（P〈0.05）,4组的Tei指数分别为0.46±0.08、0.52±0.05、0.64±0.08、0.81±0.07;4组的NT-ProBNP分别为（270.18±15.38）ng/L,（297.21±21.38）ng/L、（850.70±35.12）ng/L、（2254.52±71.91）ng/L;4组LVEF分别为64.23±7.20、61.25±5.20、52.85±9.73、38.50±8.46,对照组与A组,AB两组之间的差异无统计学意义（P〉0.05）;对照组与B组、C组,AC、BC组之间的差异具有统计学意义,4组E/A分别为0.84±0.18、0.83±0.20、0.80±0.19、0.68±0.31,对照组与A、B组之间,AB、BC之间差异无统计学意义,而AC差别有统计学意义（P〈0.05）,Tei指数与BNP呈正相关（r=0.92）,LVEF与NT-ProB-NP呈负相关（r=-0.58）,E/A与BNP无线性关系（r=0.25,P〉0.05）。结论 Tei指数与NT-ProBNP存在较好的相关性,与LVEF相比较,它们是一种无创、简便、敏感、准确评价心脏整体功能的新指标。

The Comparative Study on Heart Function Evaluated by Tei Index and NT-Pro Brain Natriuretic Eptide in Patients with Coronary Artery Disease after PCI

Objective To investigate the changement and correlation between the Tei index and NT-ProBNP and their changes in the coronary artery disease patients after percutaneous coronary intervention(PCI) with different cardiac function.Methods One hundered and Twenty patients who were diagnosed by coronary artery angiography were devided into three groups dely on NYHA,Forty patients with NYHA grade Ⅱ were in group A,40 patients with NYHA grade Ⅲ in group B,and 40 patients with NYHA grade Ⅳ in group C.The diagnostic criteria of coronary artery disease was that there was a stenosis more than 75% in left main artery or one main branch artery at least.with normal heart function were in control group.Left ventricular ejection fraction(LVEF),E/A,and Tei index were measured by echocardiography.Plasma NT-ProBNP was assayed at the same time.Results Tei index and BNP increased with the heart dysfunction aggravated(P<0.05).Tei index of the 4 groups were 0.46±0.08、0.52±0.05、0.64±0.08、0.81±0.07 respectively.NT-ProBNP of the 4 groups were(270.18±15.38)ng/L,(297.21±21.38)ng/L、(850.70±35.12)ng/L and(2254.52±71.91)ng/L respectively.There were significant differences in any two groups(P<0.05).LVEF of the 4 groups were64.23±7.20、61.25±5.20、52.85±9.73、38.50±8.46respectively.There was no significant difference in comparation the controlled group and group A,the same as the group A and B,and there were significant differences in the other groups(the controlled group between B and C,group A and C,group B and C)(P<0.05).E/A of the 4 groups were0.83±0.20、0.80±0.19、0.68±0.31respectively.There were significant differences in group A and group C(P<0.05),while,there was no significant differences in the controlled group between groupA and B,in group A and B,in group B and C(P>0.05).There was a significant negative correlation between LVEF and NT-ProBNP(P<0.05).There was also a significant positive correlation between Tei index and NT-ProBNP(P<0.05).There was no significant correlation between E/A and NT-ProBNP(P>0.05).Conclusion There is a good correlation between Tei index and NT-ProBNP,Tei index and NT-ProBNP are uninvasive,convenient,sensitive,accurate and new index that can evaluate the heart function generally.