缺血性心力衰竭中医证候与NT-proBNP及心肌损伤的相关性研究

Correlative Study on NT-ProBNP /cardiac Injury and TCM Syndromes of Ischemia Heart Failure

目的:探索缺血性心力衰竭气虚血瘀证和阳虚水停证与N端钠尿肽前体(N-terminal pro-brain natriuretic peptide,NTproBNP)及心肌损伤的相关性。方法:收集2011年11月至2012年12月于中国中医科学院西苑医院心血管科住院的缺血性心力衰竭患者36例,气虚血瘀证和阳虚水停证各18例,检测患者血中NT-proBNP及心肌肌钙蛋白T(Cardiac troponin T,cTnT)的含量,比较气虚血瘀证和阳虚水停证NT-proBNP及cTnT含量的差异,进一步对差异指标进行ROC曲线分析,计算ROC曲线下面积,分析差异指标与阳虚水停证的相关性。结果:缺血性心力衰竭阳虚水停证较气虚血瘀证NT-proBNP及cTnT含量升高(P<0.05);阳虚水停证与气虚血瘀证NT-proBNP及cTnT的ROC曲线分析显示,NT-ProBNP曲线下面积0.91,cTnT曲线下面积0.79(P<0.05);cTnT及NT-ProBNP与阳虚水停证呈正相关,相关系数为分别为0.50、0.72(P<0.05)。结论:NTproBNP及cTnT可以为缺血性心力衰竭气虚血瘀证和阳虚水停证的辨证分型提供检测依据。

Objective： To study the relation between NT-ProBNP /cardiac injury and syndrome of blood stasis caused by qi deficiency（ QDBS） and syndrome of accumulation of fluid caused by yang deficiency（ YDFA） of ischemia heart failure. Methods： Altogether 36 pa- tients were treated with QDBS（ n = 18） and YDFA（ n = 18） for ischemia heart failure and the serum levels of NT-proBNP and cTnT were detected and compared. ROC curve for different parameters of the two TCM syndromes were analyzed. The relation between the dif- ferent parameters of the two TCM syndromes and YDFA was studied. Results： NT-proBNP and cTnT levels were higher in YDFA than in QDBS; area under curve（ AUC） of NT-proBNP was 0. 91,AUC of cTnT was 0. 79; NT-proBNP / cTnT and YDFA was positively corre- lated,related coefficient was 0. 72 /0. 50 respectively（ P 0. 05）. Conclusion： NT-proBNP and cTnT could be the objective basis for distinguish QDBS and YDFA of ischemia heart failure.