慢性心衰心阴虚、心阳虚与NYHA分级及NT-proBNP关系探讨　

Study on Relationship between NT-proBNP Level,Classification of NYHA and Yang Deficiency,Yin Deficiency in Chronic Heart Failure

目的研究心力衰竭以心阴虚和心阳虚为主的患者N A分级及血浆NT-proBNP水平与中医分型之间的关系。方法将符合Framingham的心衰诊断标准患者进行NYH A分级,同时用化学发光法测定血浆NT-proBNP水平。比较不同证型心功能分级以及NT-proBNP水平的差别,并以中医证型为因变量进行Logistic回归分析,检验不同证型与心功能分级及NT-proBNP的相关性。结果83例心力衰竭患者中,心阴虚为主患者心功能分级低于心阳虚为主患者,心功能分级与证型相关性明显,NT-proBNP水平明显低于阳虚证患者。结论NYH A分级可以作为心功能分级一项参照指标;心阴虚证患者病情轻于心阳虚证患者。

Objective： To investigate the relationship between level of NT -proBNP in plasma, classification of NYHA and yang deficiency, yin deficiency in chronic heart failure. Methods： Patients diagnosed chronic heart failure by Framingham criterion were classified by grades of NYHA. Their NT - proBNP levels in plasma were tested by chemical luminescence method. The heart function and the NT- proBNP level were compared between different TCM types of syndrome. Meanwhile, TCM types of syndrome as dependent variables were analyzed by logistic regression analysis in order to prove the relativity between classification of NYHA and level of NT - proBNP in plasma. Results： It was relatively lower in patients with yin deficiency that the classification of heart function and the levels of NT- proBNP in plasma. And it was obvious in relativity between classification of NYHA and TCM types of syndrome. Conclusion： The NYHA classification system might be a reference for TCM syndrome type determination in chronic heart failure. The symptoms of patients with yang deficiency are more severe than those of yin deficiency.