NT-proBNP对心力衰竭的诊断价值及评价疗效的意义

Diagnostic value and evaluating therapeutic effects significance of NT-proBNP for chronic heart failure

目的:探讨N末端B型利钠肽(NT-proBNP)对慢性心力衰竭(CHF)的诊断价值及评价疗效的意义。方法:选择2012年12月至2014年12月期间来我院治疗的124例CHF患者。根据NYHA心功能分级法,患者被分成Ⅰ级组(31例)、Ⅱ级组(31例)、Ⅲ级组(31例)以及Ⅳ级组(31例)。测量比较4组治疗前后的NT-proBNP水平、左室射血分数(LVEF)。分析心衰严重程度、LVEF与NT-proBNP水平的相关性。结果:与治疗前比较,4组治疗后NT-proBNP水平[Ⅰ级组:(229.60±15.25)pg/ml比(72.04±6.41)pg/ml,Ⅱ级组:(1023.36±19.71)pg/ml比(121.83±10.32)pg/ml,Ⅲ级组:(2128.82±23.30)pg/ml比(240.07±11.42)pg/ml,Ⅳ级组:(3479.86±28.72)pg/ml比(352.15±13.27)pg/ml]均显著降低,P均<0.01;无论治疗前或后,NT-proBNP水平均随着心衰的加重而显著升高,两两比较均有显著差异,P均<0.01。Spearman相关分析显示NT-proBNP水平与心衰严重程度呈显著正相关(r=0.75,P=0.001),与LVEF呈显著负相关(r=-0.625,P=0.001)。结论:血NT-proBNP是诊断慢性心衰,评价其疗效的灵敏、稳定的标志物。

Objective：To explore diagnostic value and evaluating therapeutic effects significance of N terminal B-type natriuretic peptide（NT-proBNP）for chronic heart failure（CHF）.Methods：A total of 124 CHF patients who were treated in our hospital from Dec 2012 to Dec 2014 were selected.According to NYHA classification,patients were divided into classⅠ group（n=31）,classⅡ group（n=31）,classⅢ group（n=31）and classⅣ group（n=31）.NT-proBNP level and left ventricular ejection fraction（LVEF）were measured and compared among four groups before and after treatment.The correlation among severity of heart failure,LVEF and NT-proBNP level was analyzed.Results：Compared with before treatment,there were significant reductions in NT-proBNP levels [class I group：（229.60±15.25）pg/ml vs.（72.04±6.41）pg/ml,class II group：（1023.36±19.71）pg/ml vs.（121.83±10.32）pg/ml,class III group：（2128.82±23.30）pg/ml vs.（240.07±11.42）pg/ml,class IV group：（3479.86±28.72）pg/ml vs.（352.15±13.27）pg/ml]in four groups after treatment,P〈0.01all;no matter before or after treatment,NT-proBNP level significantly rose along with heart failure aggravated,there existed significant defference between any two goups,P〈0.01 all.Spearman correlation analysis indicated that NT-proBNP level was significant positively correlated with severity of heart failure（r=0.75,P=0.001）,and significant inversely correlated with LVEF（r=-0.625,P=0.001）.Conclusion：NT-proBNP is a sensitive and stable marker diagnosing chronic heart failure and evaluating therapeutic effects.