血浆N端脑钠肽前体水平与舒张性心力衰竭的相关性研究

摘要

Abjective:Objective To study the correlation between plasma N-terminal pro brain natriuretic peptide (NT-proBNP) concentration and the diastolic heart failure.Methods Selected from Mudanjiang Medical University Hongqi Hospital during Jan.2013 and Dec.2014, 60 patients diagnosed as asymptomatic diastolic dysfunction without heart failure symptoms and physical signs , left ventricular ejection fraction (LVEF) >50%, tissue Doppler ultrasound E/E′>15, New York Heart Association (NYHA) class Ⅰ, were included as asymptomatic diastolic dysfunction group;and 80 patients with heart failure symptoms and signs, LVEF>50%, tissue Doppler ultrasound E/E′>15, NYHA class Ⅱ or above,were included as diastolic heart failure group.And 80 cases of other diseases without heart failure symptoms and physical signs,LVEF>50%, without segmental abnormal ventricular wall motion and left ventricular diastolic dys-function during the same period were included as normal cardiac function group .The NT-proBNP level of the subjects were detected to compare the NT-proBNP level difference under different conditions of heart function.Results The NT-proBNP level of diastolic heart failure group was significantly higher than the asymptomatic diastolic dysfunction group and normal cardiac function group [ ( 479 ±62 ) ng/L vs (217 ±35) ng/L,(63 ±16) ng/L,P<0.05],and the asymptomatic diastolic dysfunction group was significantly higher than the normal cardiac function group ( P <0.05 ) .NYHA classification and NT-proBNP levels were positively correlated in diastolic heart failure patients ( r=0.775 , P<0.05 ) . Conclusion The NT-proBNP in patients with diastolic heart failure has varying degrees of increase , which is positively correlated with the severity of diastolic heart failure ,and can be used as early diag-nostic index for diastolic heart failure .%目的：研究血浆N端脑钠肽前体（ NT－proBNP）水平与舒张性心力衰竭的相关性。方法入选2013年1月至2014年12月牡丹江医学院红旗医院收治的无心力衰竭症状和体征，左心室射血分数（LVEF）＞50％，组织多普勒二尖瓣舒张早期血流峰值与二尖瓣环运动速度之比（E／E′）＞15，纽约心脏病协会（NYHA）分级为Ⅰ级，诊断为无症状舒张功能障碍患者60例，作为无症状舒张功能障碍组；有心力衰竭症状和体征，LVEF＞50％，组织多普勒 E／E′＞15，NYHA 分级为Ⅱ级以上，作为舒张性心力衰竭组80例。同期选择来本院就诊的无心力衰竭症状和体征，LVEF＞50％，无节段性室壁运动及左心室舒张功能异常的其他疾病患者80例，作为心功能正常组。测定受试者 NT－proBNP水平，比较不同心功能状况下NT－proBNP水平的差异。结果舒张性心力衰竭组NT－proBNP水平显著高于无症状舒张功能障碍组和心功能正常组[（479±62） ng／L比（217±35） ng／L、（63±16） ng／L， P＜0．05]。无症状舒张功能障碍组NT－proBNP水平显著高于心功能正常组（P ＜0．05）。舒张性心力衰竭患者NYHA分级与NT－proBNP水平呈正相关（r＝0．775，P ＜0．05）。结论 NT－proBNP在舒张性心力衰竭患者中有不同程度的升高，升高的程度与舒张性心力衰竭的严重程度呈正相关，可以作为舒张性心力衰竭NT－proBNP早期的诊断指标。