哈萨克族心力衰竭患者血浆和肽素、N端前体脑钠肽水平的变化及临床意义

Changes and clinical significance of copeptin and NT-proBNP levels in Kazakhs patients with heart failure

目的:探讨哈萨克族心力衰竭(心衰)患者血浆和肽素(Copeptin)、N端前体脑钠肽(NT-proBNP)水平的变化及临床意义。方法:使用酶联免疫吸附测定法(ELISA)测定90例哈族心衰患者(心衰组)和30例同期住院哈族无心功能不全患者(对照组)的血浆Copeptin、NT-proBNP水平,超声心动图测量左房内径(LAD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)、左室短轴缩短率(FS)。结果:哈族心衰患者血浆Copeptin、NT-proBNP显著高于对照组,且随NYHA心功能分级的升高而升高,各组间差异具有统计学意义(P<0.01)。心衰患者Copeption、NT-proBNP具有相关性(r=0.692,P<0.01)。单因素分析显示,Copeption、NT-proBNP与LAD、LVEDD呈正相关(均P<0.01),与LVEF、FS呈负相关(均P<0.01)。在心衰组,分别将年龄、性别、NY-HA分级、超声心动图所测LAD、LVEDD、LVEF、EF、FS共8个因素行多元逐步回归分析,结果只有NYHA和LVEF是Copeptin、NT-proBNP的独立相关因素。结论:哈族心衰患者血浆Copeptin、NT-proBNP水平显著升高,并与心衰严重程度有良好的相关性。Copeptin、NT-proBNP可以作为判断哈族心衰患者心功能的一个良好指标。

Objective：To explore the change and significance of copeptin and NT-proBNP in Kazakhs patients with heart failure（HF）.Method：The 90 Kazakhs patients with heart failure were analyzed as HF group and 30 patients without heart failure were served as control group.Every subject＇s plasma copeptin and NT-proBNP were detected by ELISA.The parameters of left atrial diameter（LAD）,left ventricle end-diastolic diameter（LVEDD）,left ventricle ejection fraction（LVEF）,fraction shortening（FS） were detected with echocardiography.Result：The plasma copeptin and NT-proBNP levels of HF group were significantly higher than control group（P0.01）.Copeptin and NT-proBNP levels also increased with the classification of NYHA（P0.01）.Correlation analysis revealed a strong correlation between copeptin and NT-proBNP（r=0.692,P0.01）.The levels of copeptin and NT-proBNP positively correlated with LAD,LVEDD（all P0.01）,and was negatively correlated with LVEF,FS（all P0.01）.Multivariate stepwise regression analysis including age,gender,NYHA classification,LAD,LVEDD,LVEF and FS revealed that only NYHA classification and LVEF were independent predictors.Conclusion：The concentration of copeptin and NT-proBNP was increased in Kazakhs Patients with heart failure,which are closely associated with NYHA grading of cardiac function.Measuring plasma copeptin and NT-proBNP level may be helpful for judging the severity of heart failure.