慢性心力衰竭患者的不同中医证型与N端脑钠肽前体的关系探讨

目的：观察慢性心力衰竭患者的不同中医证型与N端脑钠肽前体的关系。方法：153例慢性心力衰竭患者，按照郑筱萸的《中药新药临床研究指导原则》中中药新药治疗心力衰竭的临床研究指导原则分为7型，另外设健康人组，观察8组肝肾功能、N端脑钠肽前体（PRO—BNP）水平。结果：各组性别、年龄、体重等差异无统计学意义（P〉0．05）。与正常对照组比较，7种中医证型慢性心力衰竭患者的肌酐（Cr）、尿素氮（BUN）水平无明显升高，差异无统计学意义（P〉0．05）．N端脑钠肽前体水平均明显升高（P〈0．05）；7种中医证型中，又以气虚血瘀型和阴竭阳脱型慢性心力衰竭患者N端脑钠肽前体水平最高，明显高于其他5组，而气虚血瘀型和阴竭阳脱型之间N端脑钠肽前体水平比较，差异无统计学意义（P〉0．05）。结论：慢性心力衰竭患者中，以气虚血瘀证型和阴竭阳脱证型与N端脑钠肽前体关系最为密切。

Discussion of Relationship among Different TCM Syndrome Types and N Terminal Brain Natriuretic Peptide in Patients with Chronic Heart Failure

Objective： To observe the relationship between different TCM syndrome types and NT pro-brain natriuretic peptide in patients with chronic heart failure precursors. Methods： In accordance with the Guiding Principles of Clinical Research on Traditional Chinese Medicine and New Medicine for the treatment of heart failure, 153 cases of chronic heart failure patients were divided into seven groups, and a healthy group. We totally observed eight groups liver and kidney function and levels of N-terminal pro-brain natriuretic peptide. Results ： There was no statistical significance of gender, age and body weight among groups （ P 〉 0.05 ）. Compared with the normal control group, the levels of serum creatinine and blood urea nitrogen （ BUN ） of seven kinds of TCM syndrome types in patients with chronic heart failure were not increased significantly （ P 〉 0.05 ） , but the levels of N-terminal pro-brain natriuretic peptide were higher（ P 〈 0.05）. Among the seven kinds of TCM syndrome types, the levels of N-terminal pro-brain natriuretic peptide of the type of Qi deficiency and blood stasis and type of Yin-Yang dried off were the highest. They were significantly higher than the other five groups. But there was no statistical significance of the levels of N-terminal pro-brain natriuretic peptide between the type of Qi deficiency and blood stasis and Yin-Yang dried off in patients with chronic heart failure （ P 〉 0. 05）. Conclusion ： In patients with chronic heart failure, the type of Qi deficiency and blood stasis and Yin-Yang dried off were mostly closed with N-terminal pro-brain natriuretic peptide.