NT-proBNP水平与心功能分级及LVEF值的相关性

Correlation among NYHA cardiac function class,LVEF and NT-proBNP level

目的：研究血浆N末端B型利钠肽前体（NT-proBNP）水平与心功能分级及左室射血分数（LVEF）的相关性,探讨NT-proBNP与主要不良心血管事件（MACE）发生率的关系。方法：选择不同心功能水平患者243例（心功能正常者40例,心功能NYHA分级I级46例,Ⅱ级57例,Ⅲ级58例,Ⅳ级42例）,测定患者血NT-proBNP水平及LVEF,并分析NT-proBNP与心功能分级及LVEF的相关性;随访24个月观察NT-proBNP水平与MACE事件发生率的关系。结果：血浆NT-proBNP水平、MACE发生率随心功能分级增加而明显升高（P均=0.001）;Spearman相关分析显示：NT-proBNP水平与心功能分级呈明显正相关（r=0.856,P〈0.01）,与LVEF呈明显负相关（r=-0.601,P〈0.01）;随着NTproBNP水平（0-4级）升高,患者MACE发生率明显升高（分别为20%、41.3%、,50.9%、63.8%、71.4%,P=0.001）。结论：N末端B型利钠肽前体与心功能分级及左室射血分数值之间具有较好的相关性,与MACE也有关系,对诊断及预后有重要价值。

Objective： To study the correlation among NYHA cardiac function class, left ventricular ejection fraction （LVEF） and N-terminal pro-brain natriuretic peptide （NT-proBNP） and relationship between NT-proBNP and incidence rate of major adverse cardiovascular events （MACE）. Methods： A total of 243 patients with different degree cardiac function were selected, including 40 cases with normal cardiac function, 46 cases with NYHA cardiac function class Ⅰ, 57 cases with NYHA cardiac function class Ⅱ, 58 cases with NYHA cardiac function class Ⅲ and 42 cases with NYHA cardiac function class Ⅳ. Plasma NT-proBNP level and LVEF were measured and correlations a-mong NYHA cardiac function class, LVEF and NT-proBNP were analyzed; all subjects were followed up for 24 months to observe the relationship between plasma NT-proBNP level and incidence rate of MACE. Results： Plasma NT-proBNP level and incidence rate of MACE significantly rose along with NYHA cardiac function class increased, P = 0. 001 both; Spearman correlation analysis indicated that NT-proBNP level was positively correlated with NYHA cardiac function class （r = 0. 856, P〈0.01） and inversely correlated with LVEF （r = - 0. 601, P〈0.01） ; along with NT-proBNP level rose （0-4th class）, incidence rate of MACE significantly increased （namely 20%, 41.3%, 50.9%, 63.8% and 71.4% respectively, P = 0. 001）. Conclusion： NT-proBNP level is significantly correlated with NYHA cardiac function class and LVEF, and related with MACE incidence rate, which possesses important diagnostic and prognostic value.