CHF患者NT-proBNP水平和心率变异性与心功能的相关性探讨

The Correlation between NT-proBNP Level and Heart Rate Variability and Cardiac Function of Patients with CHF

目的:分析充血性心力衰竭(CHF)患者N端脑钠肽前体(NT-proBNP)浓度变化水平和心率变异性(HRV)与心功能的相关性。方法:选择82例CHF患者(观察组,n=82)和30例健康体检者(对照组,n=30)作为研究对象,观察组患者依照HYHA标准分为Ⅰ组、Ⅱ组、Ⅲ组和Ⅳ组;比较观察组和对照组NT-proBNP水平和HRV指标变化情况。结果:观察组中的Ⅱ组、Ⅲ组和Ⅳ组NT-proBNP浓度变化水平存在显著差异(P<0.05),且均高于对照组(P<0.01);观察组患者HRV指标显著高于健康组(P<0.01),且Ⅰ组、Ⅱ组HRV指标显著高于Ⅲ组和Ⅳ组(P<0.05);经多元回归分析,各组NTproBNP浓度与LVEF、LVDED存在相关性,LVEF、LVDED与RMSSD和PNN50相关。结论:CHF患者clNT-proBNP水平和心率变异性均与患者的心功能存在显著相关性;NT-proBNP水平能够为CHF的临床诊断、治疗、预后判定提供准确与量化的依据;CHF患者的HRV指标减低则提示心功能较差,且减低幅度越大,则心功能越差。

Objective： To analyze the correlation between NT-proBNP level and heart rate variability and cardiac function of patients with CHF. Method： 82 cases with CHF（ the observation group,n = 82） and30 healthy examiners（ the control group,n = 30） were selected as research objects. According to HYHA standard,the observation group was divided into group Ⅰ,group Ⅱ,group Ⅲ and group Ⅳ. NT-proBNP level and HRV index of the observation group and the control group were compared. Result： There was evident difference for NT-proBNP level in group Ⅱ,group Ⅲ and group Ⅳ of the observation group（ P 0.05）,and were higher than that of the control group（ P〈0.01）. HRV index of the observation group was evidently higher than that of control group（ P〈0.01）,and that in group Ⅰ,group Ⅱ was evidently higher than that in group Ⅲ and group Ⅳ（ P〈0.05）. Through multivariate regression analysis,there was correlation between NT-proBNP concentration and LVEF,LVDED. LVEF,LVDED and RMSSD correlate with NN50.Conclusion： NT-proBNP level and heart rate variability of patients with CHF has evident correlation with cardiac function of patients. NT-proBNP level can provide accurate and quantitative basis for clinical diagnosis,treatment and prognosis for CHF. The reduction of HRV indicator for patients with CHF indicates bad cardiac function. The greater the reduction amplitude is,the worse the cardiac function is.