血浆 N-末端脑钠肽前体和6 min 步行试验评价慢性心力衰竭的临床研究

Clinical correlation of plasma N -terminal probrain natriuretic peptide and 6 min walk test performance in patients with chronic heart failure

目的：探讨血浆 N-末端脑钠肽前体（NT-proBNP）和6 min 步行试验（6-MWT）评价慢性心力衰竭（CHF）患者心功能及预后的临床价值。方法随机选择住院的慢性心力衰竭患者100例及50例健康体检者作为对照组，根据 NYHA 心功能分级分组，心功能为Ⅱ～Ⅳ级，其中心功能Ⅱ级28例，心功能Ⅲ级56例，心功能Ⅳ级16例。入院当天测定血浆 NT-proBNP 水平和6-MWT 距离，超声心动图测定患者左室射血分数（LVEF）、二尖瓣舒张早期流速峰／二尖瓣舒张晚期流速峰值（E ／A）。结果慢性心力衰竭患者血浆 NT-proBNP水平与心功能分级呈显著正相关（r ＝0．683，P ＜0．01）；6-MWT 距离与心功能呈显著负相关（r ＝－0．518，P ＜0．01）。且血浆 NT-proBNP 水平与6-MWT 距离具有良好的相关性（r ＝－0．789，P ＜0．05）；血浆 NT-proBNP水平与舒张性心衰、收缩性心衰、混合型心衰有相关性（r ＝－0．678，P ＜0．01；r ＝－0．845，P ＜0．01；r ＝－0.759，P ＜0．01）。结论血浆 NT-proBNP、6MWT 可以评估心功能严重程度，同时 NT-proBNP 水平越高，6MWT 越短，心功能严重程度越高，预后不良。

Objective To explore the clinical effect and prognosis of plasma N -terminal probrain natriuret-ic peptide （NT -proBNP）and 6 min walk test performance （6 -MWT）in patients with chronic heart failure （CHF）.Methods 100 patients with CHF were selected as observation group,and 50 healthy people were selected as control group.They were grouped by NYHA degree,28 cases were NYHA Ⅱ,56 cases were NYHA Ⅲ and 16 cases were NYHA Ⅳ.The plasma level of NT -proBNP,6 -MWT,left ventricular ejection fraction （LVEF）,early diastolic peak mitral flow velocity to late diastolic peak mitral flow velocity （E /A）were measured.Results The plasma NT -proBNP level of CHF patients was positively correlated with NYHA degree （r =0.683,P ＆lt;0.01）;6 -MWT was neg-atively correlated with NYHA degree（r =-0.518,P ＆lt;0.01）.For CHF patients,significant correlation was observed between NT -proBNP and 6 -MWT （r =-0.789,P ＆lt;0.05）.Plasma NT -proBNP level was correlated with dias-tolic HF,systolic HF and mixed type heart failure （r =-0.678,P ＆lt;0.01;r =-0.845,P ＆lt;0.01;r =-0.759,P ＆lt;0.01）.Conclusion Plasma NT -proBNP,6 -MWT can serve as a marker for the detection and evaluation of heart failure.Meanwhile,the higher the NT -proBNP level,the shorter the 6 -MWT,the more serious the heart failure,the poorer the prognosis.