慢性心衰患者血浆脑钠肽前体N端片段测定的价值

Relation between N-terminal pro-BNP and NYHA Heart Function Classes in Patients with Chronic Left Heart Dysfunction

目的调查心功能Ⅰ～Ⅳ级心血管病患者血浆B型脑钠肽前体N端片段(NT-proBNP)水平,探讨心衰患者血浆NT-proBNP水平与心功能分级以及左室射血分数(LVEF)的关系。方法选择因慢性充血性左心衰(CHF)住院的38～80岁患者110例,对照组30例。心功能分级按照纽约心脏病协会(NYHA)对心衰患者进行分级。在RochElecsys2010全自动测定仪上使用电化学发光法测定血浆NT-proBNP浓度。结果CHF患者NT-proBNP中位数为272.15pg/ml,明显高于对照组(32.08pg/ml,P<0.01)。在CHF患者中,不同NY-HA分级的各组患者NT-proBNP水平均有显著的差异(P<0.01),随着心力衰竭严重程度的增加,NT-proB-NP水平不断升高。CHF患者NT-proBNP与LVEF值之间呈良好的负相关(r=-0.626,P<0.01);在对照组两者无相关性(P=0.647)。结论血浆NT-proBNP水平随心功能的下降而升高,临床上NT-proBNP的检测是判断心功能不全的一个非常敏感的指标。对诊断心衰有帮助,可能会成为临床应用的常规检测指标。

Objective To study correlations between NT-proBNP level and left ventricular ejection fraction （LVEF）in various degrees of chronic left heart failure （ CHF ） in China. Methods The 110 patients （aged 38 -80 years） with CHF were included in this study. And 30 patients with cardiac neurosis were analyzed as control. Plasma NT - proBNP level was measured by the Roch NT - proBNP electrochemiluminescent assay. Results Median levels of NT - proBNP are higher in patients with CHF than that of controls （272. 15pg/ml vs 32.08 pg/ml P 〈 0. 01 ） . And median levels of NT - proBNP increased gradually in CHF patients, which associated with NYHA heart function classes in- creased by degrees （P 〈 0. O1 ）. There were close relation between NT - proBNP and LVEF （r = - 0. 626, P 〈 0. 01 ） in CHF patients, but no relation in controls （P = 0. 647） . Conclusion Lev- els of NT proBNP are higher in patients with CHF than the controls, which are increased gradually and associated with NYHA heart function classes successful by degrees. Measurement of brain natriuretic peptides is useful for the diagnosis of CHF.