脑钠肽和心阻抗图参数在缺血性心肌病患者中的相关性分析

Correlation between parameters of impedance cardiogram and BNP in patients with ischemic cardiomyopathy

目的 :评估心阻抗图与脑钠肽(brain natriuretic peptide,BNP)在监测缺血性心肌病患者常规治疗前后中的相关性。方法:检测30例缺血性心肌病患者常规治疗前后的BNP。利用心阻抗监测仪器观察治疗前后每搏心输出量(stroke volume,SV)、每分心输出量(cardiac output,CO)、心肌收缩加速度指数(acceleration index,ACI)、平均动脉血压(mean arterial pressure,MAP)、外周血管阻力(systemic vascular resistance,SVR)、左心室做功指数(left cardiac work index,LCWI)、胸腔液体量(thoracic fluid content,TFC)、射血前期(pre-ejection period,PEP)、左心室射血时间(left ventricular ejection time,LVET)、收缩时间比率(systolic time ratio,STR)(STR=PEP/LVET)等多项参数的变化,并分析治疗前后参数差值与BNP变化的相关性。结果:比较治疗前后的心阻抗参数和BNP,提示缺血性心肌病患者治疗后血流动力学有明显改善,且其中CO、ACI、STR、TFC与BNP水平间具有相关性(r=-0.428、-0.845、0.564、0.410,P均<0.05)。结论 :部分心阻抗图参数与缺血性心肌病患者BNP水平密切相关,且可更具体地评估缺血性心肌病患者的血流动力学。

Objective： To investigate the correlation between changes in parameters of non-invasive hemodynamic monitor（ICG） and brain natriuretic peptide（BNP）for evaluating the cardiac function of ischemic cardiomyopathy patients before and after treatment. Methods： Thirty patients with ischemic dilated cardiomyopathy were enrolled. BNP levels were detected before and after treatment. Changes in ICG parameters such as SV, CO, ACI, MAP, SVR, LCWI, TFC, PEP,LVET, STR before and after treatment were measured. Correlations between changes of ICG parameters and changes of BNP levels were analyzed. Results： Analysis of levels of BNP and some important parameters of ICG indicated that the hemodynamics of ischemic dilated cardiomyopathy patients were improved after treatment, and the changes of ACI, CO,STR had a significant correlation with that of BNP. Conclusions： Some of the parameters of ICG are correlated with BNP level in patients with ischemic dilated cardiomyopathy,and could be used to evaluate the cardiac hemodynamics.