NT-proBNP与左心室舒张功能的相关性

RELATIONSHIP OF NT-proBNP AND DIASTOLIC FUNCTION OF THE LEFT VENTRICELE

目的探讨血浆氨基末端前体脑钠肽(NT-proBNP)与左心室舒张功能的关系。方法选择超声心动图检查左心室射血分数≥45%的单纯舒张功能不全病人53例为研究组,左心室舒张功能正常34例为对照组,应用电化学发光法检测血浆NT-proBNP水平,左心导管检测左心室舒张功能,分析NT-proBNP水平与左心室舒张功能的相关性。结果研究组NT-proBNP水平高于对照组,差异有显著性(t=77.237,P<0.001)。左心室舒张末期压(AUC 0.82)是诊断左心室舒张功能不全特异度最高的指标,但其敏感度较低(73%)。NT-proBNP诊断左心室舒张功能不全的阴性预测因子为93%,并且与侵入性检查指标左心室舒张末期压相关(r=0.48,P<0.01)。结论血浆NT-proBN水平可以作为评价有呼吸困难症状病人左心舒张功能不全的客观指标。

Objective To investigate the relationship between N-terminal pro-brain natriuretic peptide （NT proBNP） and left ventricular diastolic function. Methods Fifty-three patients with merely isolated diastolic dysfunction were enrolled as study group and 34 adults with normal left ventricular function served as control group. Plasma NT-proBNP levels were detected by electrochemical radiation and left ventricular diastolic function checked by left heart catheterization. The correlation between NT proBNP levels and diastolic function of the left ventricle was analyzed. Results Plasma NT-proBNP in study group was higher than that of the control, the difference being significant （t=77. 237, P〈0. 001）. Left ventricular end diastolic pressure （area under the curve （AUC） 0.82） was the most specific parameter, but with a lower sensitivity （73 %）. NT proBNP had the best negative predictive value of all methods （93 %） and correlated with indices of left ventricular end diastolic pressure （r= 0.48, P〈0.01） as determined by invasive measurements. Conclusion Plasm level of NT-proBNP can be regarded as a reliable parameter to detect the presence of isolated diastolic dysfunction in symptomatic patients.