高危队列人群血浆氨基末端脑钠肽前体浓度与左室舒张功能相关性的探讨

Relationship between N-terminal pro-brain natriuretic peptide and diastolic heart function on the population in community at high risk of developing cardiovascular diseases

目的:探讨社区心血管疾病高危队列人群血浆氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)浓度与左室舒张功能分级的关系。方法:横断面调查北京首钢社区733例具有心血管病高危因素的人群,运用电化学发光免疫技术测定血浆NT-proBNP浓度。行超声心动图测量左室射血分数(LVEF),并依据二尖瓣口血流多普勒、二尖瓣环组织多普勒、肺动脉血流多普勒对LVEF正常者进行左室舒张功能分级(正常、轻度受损、中/重度受损、未定型);分析LVEF正常者血浆NT-proBNP浓度正常与升高者左室舒张功能差异,以及左室舒张功能分级与血浆NT-proBNP浓度的相关性。结果:在LVEF正常的人群中,血浆NT-proBNP浓度正常者与升高者的左室舒张功能分级差异有统计学意义(P=0.012),年龄、性别、心率与血浆NT-proBNP浓度相关,校正上述因素后左室舒张功能分级(rp=0.053,P=0.021)与血浆NT-proBNP浓度独立相关。结论:LVEF正常人群中血浆NT-proBNP浓度升高者其左室舒张功能减低,而且左室舒张功能受损程度与血浆NT-proBNP浓度呈正相关,血浆NT-proBNP浓度升高可作为左室舒张功能受损早期诊断、干预的依据。

Objective：To analyze the relationship between N-terminal pro-brain natriuretic peptide and diastolic heart function on the population in community at high risk of developing cardiovascular diseases.Method：The automated electrochemiluminescence immunoassay was used to measure concentration of serum NT-proBNP,and images was consecutively collected with Echocardiography.Totally 733 people in Peking Shougang community at high risk of developing cardiovascular diseases was cross-sectional studied.Left ventricular ejection fraction（LVEF） were measured,diastolic heart function was classified by Doppler images of mitral inflow maneuver,Doppler images of pulmonary venous flow,and Doppler tissure images of mitral annular motion.The diastolic heart function of those whose LVEF are normal ware were analyzed,they ware were grouped by if the serum NT-proBNP is normal or not.And the relationship between serum NT-proBNP and diastolic heart function was also assessed.Result：The difference of diastolic heart function was significant in each group if serum NT-proBNP was normal or not（P=0.012）.Age,sex,heart rate respectively correlated with serum NT-proBNP,and after adjusting those factors the diastolic heart function independently correlated with serum NT-proBNP.Conclusion：The diastolic heart function of population with normal LVEF and higher serum NT-proBNP is impaired.And the diastolic heart function positive correlated with serum NT-proBNP.So serum NT-proBNP can be an objective index which can reflect the diastolic heart function.