氨基末端脑利钠肽前体对无症状性心功能不全诊断价值的研究

Diagnostic Value of N-terminal Brain Natriuretic Peptide Prohormone in Asymptomatic Patients with Cardiac Dysfunction

【目的】探讨无症状性心功能不全患者氨基末端脑利钠肽前体（NT-proBNP）血浆浓度的变化规律，为早期诊断心功能不全提供依据。【方法】选择在本院住院无心功能不全症状的高危者120例作为研究对象，检测其NT—proBNP浓度，依据NT-proBNP水平将120例受试者分为NT—proBNP升高组（试验组）和NT-proBNP正常组（对照组），并进行心脏彩色多普勒超声检查，测定其左室射血分数（LVEF）、舒张早期心室最大充盈速度／舒张晚期心室最大充盈速度（E／A）、左室舒张末期内径（LVEDD）、室间隔厚度（IVST）、左室后壁厚度（LVPWT）、左室短轴缩短分数（FS），对两组样本各项心功能指标进行比较分析，并对NT—proB—NP水平和各项心功能指标进行相关性分析。【结果】试验组左室收缩功能和舒张功能各指标均较对照组差（P〈0．05），提示存在心功能不全。【结论】无症状人群血浆NT—proBNP浓度升高提示心功能不全，NT—proBNP可作为心功能不全的早期诊断依据之一，其升高程度与心功能受损程度呈正相关。

[Objective]To investigate plasma level of N-terminal brain natriuretic peptide prohormone （NT-proBNP） and its correlation with cardiac functions in order to evaluate the potential diagnostic and prognostic values of NT-proBNP in asymptomatic patients with cardiac dysfunction. [Methods] The plasma levels of NT-proBNP in 120 asymptomatic patients with different cardiac risk factors were measured. All patients were divided into the experimental group with elevated NT-proBNP and control group with normal NT-proBNP. Left ventricular ejection fraction （LVEF）, maximum early diastolic ventricular filling velocity / late diastolic ventricular filling maximum speed （E / A）, left ventricular end diastolic diameter （LVEDD）, interventricular septum thickness （IVST）, left ventricular posterior wall thickness （LVPWT） and left ventrieular shortening fraction （FS） were measured in both groups by using color cardiac Doppler ultrasound. The correlation between plasma concentration of NT-proBNP and the above parameters of cardiac function in two groups were analyzed. [Results]Both left ventricular systolic and diastolic functions were better in the control group than those in the experimental group （ P〈0.05）, suggesting that the plasma level of NT-proBNP was correlated with left cardiac function. [Conclusion] An elevated plasma concentration of NT-proBNP in asymptomatic cases indicates a deteriorating cardiac function. NT-proBNP may be a useful biomarker in early diagnosis of cardiac dysfunction.