收缩性心力衰竭和舒张性心力衰竭患者血浆N末端B型利钠肽原的对比分析及与年龄的关系

Plasma level of N-terminal pro-brain natiuretic peptide in systolic vs diastolic heart failure and its relationship with age

目的 探讨收缩性心力衰竭（HF）和舒张性HF患者血浆N末端B型利钠肽原（NT-proBNP）的差异及与年龄的关系。方法 收入2010年1月至2011年10月在山西省晋城市人民医院心内科住院的202例心力衰竭患者，其中收缩性HF 104例，舒张性HF 98例，所有患者均具有HF的症状、体征并行超声心动图检查。202例患者初次入院后判断纽约心脏病协会（NYHA）心功能分级，行超声心动图检查，入院后初始测定血浆NT-proBNP，比较其在收缩性与舒张性HF中的差别，并比较不同心功能组、不同年龄组血浆NT-proBNP的差异，并设20例健康人作为对照组。结果 收缩性HF、舒张性HF组血浆NT-proBNP均较正常对照组明显升高（P＜0.01），收缩性HF组血浆NT-proBNP显著高于舒张性HF组（P＜0.05）。在任何年龄组，随着NYHA心功能分级的增高，NT-proBNP浓度升高（P＜0.05）。随着年龄增长，NT-proBNP浓度呈现上升趋势，但差异未达统计学意义（P＞0.05）。结论 收缩性HF患者血浆NT-proBNP水平高于舒张性HF患者，HF患者血浆NT-proBNP与NYHA心功能分级密切相关。NT-proBNP浓度与年龄无显著相关性。

Objective To determine the plasma level of N-terminal pro-brain natriuretic peptide（NT-proBNP） between patients with systolic or diastolic heart failure （HF） and the relationship with age. Methods A total of 202 patients diagnosed with HF （104 cases with systolic HF, and 98 cases with diastolic HF） admitted in our department from January 2010 to October 2011 were enrolled in this study. They all presented the signs and symptoms of HF, and identified with echocardiography. These patients were divided into Ⅱ to Ⅳ class according to New York Heart Association Functional Classification （NYHA）, plasma level of NT-proBNP was measured in the systolic and diastolic HF groups on admission, and the results were compared among different HF groups and age groups. Twenty sex- and age-matched healthy individuals served as normal control. Results The median NT-proBNP level was significantly higher in systolic HF and diastolic HF group than in healthy control （P〈0.01）, and that of systolic HF group was significantly higher than that of diastolic HF group （P〈0.05）. The level was increased with the increase of NYHA class, that is, significantly higher in NYHA class Ⅳ than in NYHA class Ⅲ and in NYHA class Ⅱ （P〈0.05） in every age group. The level was also in a trend of elevation along with aging, though without statistical significance （P〉0.05）. Conclusion The median plasma NT-proBNP level is significantly higher in systolic HF than in diastolic HF, and it has a close relationship with NYHA class. NT-proBNP level is not significantly correlated with age.