甲亢性心脏病患者血浆NT-proBNP水平与左室功能关系的研究

摘要

目的 研究甲亢性心脏病患者血浆NT-proBNP水平与左心室功能改变之间的关系,以寻求早期诊断甲亢性心脏病的方法.方法 选取确诊的甲亢患者30例(甲亢组),甲亢性心脏病患者22例(甲亢心脏病组),及同期健康体检者25例(对照组),分别为其进行心脏彩色多普勒超声检查及血浆NT-proBNP浓度检测.结果 甲亢心脏病组二尖瓣血流频谱E/A值及EF值为(0.89±0.18)%和(62.96±4.09)%,明显低于甲亢组及对照组(P<0.05);其血浆NT-proBNP浓度为(599.31±225.64)pg/mL,明显高于甲亢组及对照组(t值分别为96.7099和167.8005,P<0.01).以NT-proBNP>298.79 pg/mL为界点诊断甲亢心脏病,其灵敏度为95.45%,特异度为90%.甲亢性心脏病组血浆NT-proBNP浓度与二尖瓣血流频谱E/A值呈负相关(r=-0.9805,P<0.01).结论 血浆NT-proBNP水平结合二尖瓣血流频谱E/A值可用于早期诊断甲亢性心脏病,并评估左室功能受损程度.%Objective To investigate the relationship between N-terminal pro-B-type Natriuretic Peptide(NT-pro BNP) and left ventricular function in patients with hyperthyroid cardiopathy,and the application in early diagnose of hyperthyroid cardiopathy.Methods Thirty cases of hyperthyroidism patients were selected as hyperthyroidism group and 22 cases of hyperthyroid cardiopathy patients as hyperthyroid cardiopathy group.We chose 25 healthy people as control group.All patients were measured the level of plasma NT-proBNP and conducted color Doppler echocardiography.Results The ratio of E/A and EF were (0.89±0.18)% and (62.96±4.09)%, respectively in hyperthyroid cardiopathy group.They were lower than those in hyperthyroidism group and control group (P<0.05).The level of plasma NT-proBNP in hyperthyroid cardiopathy group was significantly higher than that in hyperthyroidism group and control group (t=96.7099, P<0.01;t=167.8005, P<0.01).When the level of plasma NT-proBNP was higher than 298.79 pg/mL, the sensitivity was 95.45% and specificity 90% in the diagnosis of hyperthyroid cardiopathy.The level of NT-proBNP was negatively correlated with the ratio of E/A in hyperthyroid cardiopathy group(r=-0.9805,P<0.01).Conclusion Hyperthyroid cardiopathy can be diagnosed at early stage by the level of NT-proBNP combining with the ratio of E/A,and left ventricular function can also be assessed.