慢性心力衰竭患者血浆N端前体脑钠肽及尿酸水平测定的临床意义

Clinical significance of determination of plasma NT-proBNP and UA levels in patients with chronic heart failure

目的探讨慢性心力衰竭(CHF)患者血浆N端前体脑钠肽(NT-pro BNP)及尿酸(UA)水平测定的临床意义。方法选取108例CHF患者为研究对象(CHF组),根据纽约心脏病协会(NYHA)心功能分级将入选患者分为Ⅱ级32例、Ⅲ级46例、Ⅳ级30例,对照组为60例同期健康体检者。比较两组血浆NT-pro BNP及UA水平、左心房舒张末期内径(LADd)、左心室舒张末期内径(LVDd)、左心室射血分数(LVEF)以及不同心功能分级CHF患者NT-pro BNP及UA水平。将心功能Ⅲ级的患者分为常规组与联合组,常规组给予常规抗心衰治疗,联合组在常规抗心衰治疗的基础上实施别嘌呤醇治疗。结果 CHF组血浆NT-pro BNP及UA水平、LADd、LVDd均明显高于对照组(P<0.05),LVEF明显低于对照组(P<0.05);不同心功能分级患者血浆NT-pro BNP及UA水平比较差异有统计学意义(P<0.05),血浆NT-pro BNP及UA水平随心衰严重程度增高而明显增高;联合组治疗后血浆UA水平明显下降(P<0.05),LVEF明显升高(P<0.05),改善程度均高于常规组(P<0.05)。结论 CHF患者血浆NT-pro BNP及UA水平随心衰严重程度增加而升高,血浆NT-pro BNP及UA水平测定对CHF的诊断和治疗具有重要意义。

Objective To explore the clinical significance of determination of plasma N-terminal pro-brain natriuretic peptide（NT-proBNP）and uric acid（UA）levels in patients with chronic heart failure（CHF）. Methods 108 cases of patients with chronic heart failure were chosen as the research objects（CHF group）,and were divided into cardiac function grade Ⅱ（n=32）,grade Ⅲ（n=46）,grade Ⅳ（n=30）according to New York heart association（NYHA）cardiac function classification;60 cases of healthy people were chosen as control group. Plasma NT-proBNP and UA levels,left atrial end- diastolic dimension（LADd）,left ventricular end-diastolic diameter（LVDd）,and left ventricular ejection fraction（LVEF）were compared among two groups,and plasma NT- proBNP and UA levels between CHF patients with different cardiac function classification. The CHF patients with cardiac function grade Ⅲ were divided into conventional group and joint group. The patients in conventional group were given conventional anti-heart failure treatment;the patients in joint group were treated with allopurinol on the basis of conventional anti-heart failure treatment. Results Plasma NT-proBNP and UA levels,LADd,and LVDd in CHF group were significantly higher than those in control group（P〈0.05）. LVEF in CHF group were significantly lower than that in control group（P〈0.05）. Plasma NT-proBNP and UA levels in patients with different cardiac function grade were compared,and the difference were statistically significant（P〈0.05）;plasma NT-proBNP and UA levels were obviously increased with severity of heart failure. In the join group,plasma UA level was significantly decreased after treatment（P〈0.05）,and LVEF was increased significantly（P〈0.05）;the improved degrees of UA and LVEF in joint group were higher than those in conventional group（P〈0.05）. Conclusion Plasma NT-proBNP and UA levels in patients with CHF increased with the increase of heart failure severity,and the determination of plasma NT-proBNP and UA levels was of great significance for the diagnosis and treatment of CHF.