慢型克山病患者血清N末端B型钠尿肽原水平与心脏超声指标相关性研究

Correlation between serum N-terminal pro-B-type natriuretic peptide level and echocardiographic parameters in patients with chronic Keshan disease

目的探讨慢型克山病患者血清N末端B型钠尿肽原(NT-proBNP)水平与心脏超声指标的相关性,为慢型克山病诊断及预后评估提供参考依据。方法选择2020年1-12月在甘肃省平凉市泾川县人民医院规范治疗的99例慢型克山病患者,美国纽约心脏病协会(NYHA)心功能分级为Ⅱ(n=16)、Ⅲ(n=69)、Ⅳ级(n=14),对患者进行超声心动图检查,并采用荧光免疫层析法测定患者血清NT-proBNP水平,比较不同心功能分级患者血清NT-proBNP水平差异,并分析心功能分级、血清NT-proBNP水平、心脏超声指标的相关性。结果心功能分级Ⅱ、Ⅲ、Ⅳ级患者血清NT-proBNP水平分别为(1107.26±268.03)、(2125.98±293.02)、(8268.59±2659.50)pg/ml,三者比较差异有统计学意义(F=13.94,P<0.001)。血清NT-proBNP水平与心功能分级呈正相关(r=0.44,P<0.001);与左室舒张期末内径、左室收缩期末内径、左房内径均呈正相关(r=0.45、0.52、0.38,均P<0.001),与短轴缩短率、左室射血分数均呈负相关(r=-0.39、-0.46,均P<0.001)。结论不同心功能分级的慢型克山病患者血清NT-proBNP水平不同,并与心脏超声反映心脏结构、功能受损害程度的指标呈正相关。NT-proBNP水平可能成为慢型克山病早期诊断、分级和预后的评估指标。

Objective To study the correlation between serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)level and echocardiographic parameters in patients with chronic Keshan disease,providing reference for diagnosis and prognosis evaluation of chronic Keshan disease.Methods Ninety-nine patients with chronic Keshan disease who received standardized treatment at Jingchuan County People's Hospital in Pingliang City,Gansu Province from January to December 2020 were selected.Among them,16 patients were classified as cardiac function gradeⅡaccording to New York Heart Association(NYHA),69 as gradeⅢand 14 as gradeⅣ.The patients underwent echocardiography and their serum NT-proBNP level was measured using fluorescence immunochromatography.The differences in serum NT-proBNP levels among patients with different cardiac function grades were compared,and the correlation between cardiac function grades,serum NT-proBNP level and echocardiographic parameters was analyzed.Results The serum NT-proBNP levels in patients with cardiac function gradesⅡ,Ⅲ,andⅣwere(1107.26±268.03),(2125.98±293.02),and(8268.59±2659.50)pg/ml,respectively.The differences among the three groups were statistically significant(F=13.94,P<0.001).The serum NT-proBNP level was positively correlated with cardiac function grades(r=0.44,P<0.001),left ventricular end-diastolic diameter,left ventricular end-systolic diameter,and left atrial diameter(r=0.45,0.52,0.38,P<0.001),and negatively correlated with fractional shortening and left ventricular ejection fraction(r=-0.39,-0.46,P<0.001).Conclusions The serum NT-proBNP level in patients with chronic Keshan disease with different cardiac function grades is different,and is positively correlated with echocardiographic parameters reflecting the degree of cardiac structural and functional impairment.The NT-proBNP level may become an early diagnostic,grading,and prognostic indicator for chronic Keshan disease.