维吾尔族风心病患者NT-proBNP与心功能及预后的关系

Correlation among cardiac function and prognosis and NT-proBNP in Uygur nationality patients with rheumatic heart disease

目的:探讨维吾尔族风湿性心脏病(风心病)患者N末端脑利钠肽前体(NT-proBNP)与心功能及预后的关系。方法:选择我院收治的76例维吾尔族风心病患者(维族风心病组),包括NYHA心功能II级~IV级患者;并选择同期54例汉族风心病患者(汉族风心病组),检测NT-proBNP水平及心功能指标,采用Spearman相关分析探讨上述指标与心功能及预后的相关性。结果:汉族风心病组血清NT-proBNP水平显著高于维族风心病组(P=0.008);随着维族风心病患者NYHA心功能II^IV级的增加,NT-proBNP[(105.82±93.60)pg/ml比(129.38±108.37)pg/ml比(177.40±131.64)pg/ml]水平显著上升(P均<0.01);左室舒张末期内径(LVEDd)、左房内径(LAD)、右室内径(RVD)、右房内径(RAD)显著增加,左室射血分数(LVEF)显著降低(P<0.05或<0.01);Spearman相关性分析显示,NT-proBNP与维族风心病患者LVEDd、LAD、RVD、RAD均呈显著正相关(r=0.462~0.645,P均<0.05),与LVEF呈显著负相关(r=-0.682,P=0.013);76例患者均获得有效随访,其中3年死亡11例(14.5%),死亡组患者入院时NT-proBNP水平均显著高于存活组[(189.26±94.53)pg/ml比(150.41±88.30)pg/ml,P=0.018]。结论:维吾尔族风心病患者NT-proBNP水平升高提示其心功能下降、预后较差。

Objective：To explore correlation among cardiac function and prognosis and N-terminal pro brain natriuretic peptide（NT-proBNP）in Uygur nationality patients with rheumatic heart disease（RHD）.Methods：A total of76 Uygur nationality RHD patients treated in our hospital were selected as Uygur RHD group,including NYHA class II to NYHA class IV;another 54 Han nationality RHD patients were selected simultaneously as Han RHD group.NT-proBNP level and cardiac function indexes were measured,and Spearman correlation analysis was used to explore the correlation among above indexes,cardiac function and prognosis.Results：Serum NT-proBNP level in Han RHD group was significantly higher than that of Uygur RHD group,P=0.008;along with NYHA class II-IV rose,there was significant rise in NT-proBNP level[（105.82±93.60）pg/ml vs.（129.38±108.37）pg/ml vs.（177.40±131.64）pg/ml],P〈0.01all;significant rise in left ventricular end-diastolic dimension（LVEDd）,left atrial diameter（LAD）,right ventricular diameter（RVD）and right atrial diameter（RAD）,and significant reduction in left ventricular ejection fraction（LVEF）in Uygur RHD group,P〈0.05or0.01.Spearman correlation analysis indicated that NT-proBNP level was significant positively correlated with LVEDd,LAD,RVD and RAD（r=0.462-0.645,P〈0.05all）,and significant inversely correlated with LVEF（r=-0.682,P=0.013）in Uygur RHD patients.There were 11cases（14.5%）died within three years.Compared with survival group,there was significant rise in NT-proBNP level[（150.41±88.30）pg/ml vs.（189.26±94.53）pg/ml,P=0.018]at hospitalization in death group.Conclusion：Elevated NT-proBNP level suggests cardiac function reduction and poor prognosis in Uygur nationality patients with rheumatic heart disease.