NT-proBNP与早期心力衰竭超声心动图指标的相关性

目的探讨血浆N末端B型利钠肽原（N-terminal pro-B-type natriuretic peptide,NT-proBNP）对早期心力衰竭患者的预告与超声心动图指标的相关性。方法将无心力衰竭症状（心力衰竭A、B期）心血管病住院患者按血浆NT-proBNP水平分为高NT-proBNP组80例,低NT-proBNP对照组78例,利用超声心动图测定每组患者的左室舒张末内径（LVEDD）、左房内径（LAD）、左室射血分数（LVEF）,二尖瓣舒张早期流速峰值（E峰）,二尖瓣舒张晚期流速峰值（A峰）和E/A比值,E峰下降时间（EDT）及左室等容舒张时间（IVRT）,对结果进行统计学处理。结果高NT-proBNP组与对照组LAD、LVEDD、LVEF、EDT、IVRT、E/A差异有统计学意义（P〈0.01）,NT-proBNP与LAD、LVEDD、EDT、IVRT呈正相关（分别为r=0.683、0.325、0.563、0.664,均为P〈0.01）,与LVEF、E/A呈负相关（分别为r=-0.432、-0.643,均为P〈0.01）。结论临床上对心力衰竭A、B期的患者进行血浆NT-proBNP测定,并结合超声心动图指标有助于心力衰竭早期的预告和诊断。

Relativity between NT-proBNP and early heart failure echocardiography index

Objective To discuss the relativity of blood plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in forecast of early heart failure patients and echocardiographic indexs. Methods Hospitalized patients with cardiovascular disease of no heart failure symptoms (A, B stage of heart failure) were divided into the high NT-proBNP group (n = 80) and the low NT-proBNP group (n = 80), according to the NT-proBNP level, echocardiography was used to detect the left ventricular end-diastolic diameter (LVEDD), left atrial diameter (LAD), left ventricular ejection fraction (LVEF), arly diastolic peak flow velocity (E peak), end diastolic peak flow velocity (A peak) and E/A ratio, E peak decrease time (EDT) and left ventricular isovoiumetric relaxtion time (IVRT) of all patients, and the results were analyzed statistically. Results The differences of LAD, LVEDD, LVEF, EDT, IVRT, E/A between the high NT-proBNP group and the control group were statistically significant (P < 0.01); NT-proBNP had positive correlation with LAD, LVEDD, EDT, IVRT (r = 0.683, 0.325, 0.563, 0.664, all P < 0.01), and which had negative correlation with LVEF, E/A (r = -0.432, -0.643, all P < 0.01). Conclusion Blood plasma NT-proBNP determination in clinic for heart failure patients of A and B stage combined with echocardiography indexes can help with forecast and diagnosis of heart failure.