血N端B型钠尿肽原对心力衰竭诊断价值及与心功能分级关系的探讨

Study on value of N-terminal proBNP to the diagnosis of heart failure and its relationship with cardiac functional grading

目的:评价血N-端B型钠尿肽原水平对心力衰竭的诊断价值及与心功能分级之间的相关性。方法:对122例心血管疾病患者根据NYHA心功能分级分为Ⅰ、Ⅱ、Ⅲ、Ⅳ组。同期本院体检中心健康体检者20例作为对照组。测定血N-端B型钠尿肽原浓度,心脏超声测量左室舒张末内径、左室短轴缩短率、左室射血分数等指标。其中20例患者于抗心力衰竭治疗10d后复测血N-端B型钠尿肽原浓度,进行统计学分析。结果:心力衰竭患者血N-端B型钠尿肽原浓度随NYHA分级增加而增高,且均高于对照组(P<0.01)。对照组、NYHAⅠ、Ⅱ组间的左室舒张末内径、左室短轴缩短率和左室射血分数差异无统计学意义(P>0.05)。NYHA分级与N-端B型钠尿肽原及左室舒张末内径呈正相关性,与左室短轴缩短率和左室射血分数呈负相关,其中与N-端B型钠尿肽原相关程度最高。结论:N-端B型钠尿肽原水平在心力衰竭患者中明显升高,是反映心力衰竭严重程度的指标。

Objective To evaluate the value of N-terminal proBNP to the diagnosis of heart failure and the its relationship with cardiac functional grading. Methods One hundred and twenty-two patients with cardiovascular disease were divided into NYHA Ⅰ、Ⅱ、Ⅲand Ⅳ groups. Another 20 normal people were as controls. Blood concentration of N terminal proBNP was measured. Echocardiographic measurements of LVDD, LVFS and LVEF were performed. Blood concentration of N-terminal proBNP was measured again in 20 patients after anti-heart failure therapy for 10 days. Results The blood concentration of N-terminal proBNP was increased with NYHA grade and was higher than that in control group （P〈0.01）. There was no statistic difference of values of LVDD, LVFS and LVEF among NYHAⅠ, NYHA Ⅱ and control groups（P〉0.05）. NYHA grading was positively correlated with N-terminal proBNP and LVDD, but negatively correlated with LVFS and LVEF. The correlation between NYHA and N-terminal proBNP was most significant. Conclusion The blood N-terminal proBNP increases significantly and it is an index to assess the severity of heart failure.