心力衰竭超声指数及N末端脑钠肽前体对慢性心力衰竭患者心功能的评估价值

摘要

目的 探讨心力衰竭超声指数及N末端脑钠肽前体(NT-proBNP)对慢性心力衰竭(CHF)患者心功能的评估价值.方法 选取2015年1月~2016年6月于廊坊市第四人民医院就诊的CHF患者92例(心衰组),根据纽约心功能分级(NYHA分级)分为心功能Ⅰ级10例、心功能Ⅱ级21例、心功能Ⅲ级33例和心功能Ⅳ级28例,根据左室射血分数(LVEF)分为舒张性心力衰竭者29例和收缩性心力衰竭者63例.对照组为性别与年龄与心衰组相匹配的健康体检者50例.对所有入选者进行心衰超声指数评分和血浆NT-proBNP水平测定.结果 ①与对照组相比,心衰组心力衰竭超声指数、血浆NT-proBNP水平升高及LVEF降低,差异有统计学意义(P<0.05).随着心功能分级的增高,心衰超声指数评分与血浆NT-proBNP水平逐渐升高,LVEF逐渐下降,组间比较差异有统计学意义(P<0.05).②收缩性心力衰竭患者心衰超声指数评分、血浆NT-proBNP水平高于舒张性心力衰竭患者,差异有统计学意义(P<0.05).③血浆NT-proBNP水平与心衰超声指数呈正相关,差异有统计学意义(r=0.826,P<0.05),与LVEF呈负相关,差异有统计学意义(r=-0.613,P<0.05).结论 心力衰竭超声指数评分和血浆NT-proBNP可进一步提高CHF的临床诊断水平,可作为综合评价CHF患者心功能状态的重要指标.%Objective To investigate the appraisal value of heart failure echocardiography index (HFEI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) to heart function in patients with chronic heart failure (CHF). Methods CHF patients (n=92) were chosen (CHF group) from the Fourth People's Hospital of Langfang City from Jan. 2015 to June 2016, and then divided, according to NYHA standard, into class I group (n=10), class II group (n=21), class III group (n=33) and class IV group (n=28). All patients were again divided into diastolic heart failure group (n=29) and systolic heart failure group (n=63) according to left ventricular ejection fraction (LVEF). The healthy controls (n=50) with matched sex and age were chosen into control group. The scores of HFEI and level of plasma NT-proBNP were detected in all groups.Results ①HFEI and level of plasma NT-proBNP increased and LVEF decreased in CHF group compared with control group (P<0.05). As the increase of NYHA class, the scores of HFEI and level of plasma NT-proBNP increased gradually, and LVEF decreased gradually, and comparison among groups had statistical difference (P<0.05). ②The scores of HFEI and level of plasma NT-proBNP were higher in systolic heart failure group than that in diastolic heart failure group (P<0.05). ③The level of plasma NT-proBNP was positively correlated to HFEI (r=0.826,P<0.05), and negatively correlated to LVEF (r=-0.613,P<0.05).Conclusion The scores of HFEI and level of plasma NT-proBNP can further improve the diagnostic level of CHF in clinic, which can be taken as an important indicator for reviewing comprehensively heart function in CHF patients.