老年慢性心衰患者血清N末端脑钠肽前体水平的临床意义

Clinical Significance of Serum N-Terminal Pro-Brain Natriuretic Peptide Level in Elderly Patients with Chronic Heart Failure

目的探讨老年慢性心力衰竭患者血清N末端脑钠肽前体(NT-pro BNP)水平的临床意义。方法收集2015年1月至2016年1月期间我院收治的45例老年慢性心力衰竭患者,按照NYHA心功能分级分为:Ⅰ~Ⅱ级组20例,Ⅲ~Ⅳ级组25例;选择同期健康体检者45例作为对照组。采用酶联免疫法检测三组的心肌肌钙蛋白(CTNI)、NT-pro BNP,采用超声诊断仪检测左心室功能。比较三组的CTNI、NT-pro BNP、左心功能指标,并分析NT-pro BNP和左心功能指标的关系。结果 (1)与对照组相比,Ⅰ~Ⅱ级组、Ⅲ~Ⅳ级组的CTNI、NT-pro BNP明显更高(P<0.05);与Ⅰ~Ⅱ级组相比,Ⅲ~Ⅳ级组的CTNI、NT-pro BNP明显更高(P<0.05)。(2)和对照组相比,Ⅰ~Ⅱ级组和Ⅲ~Ⅳ级组的左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)明显更大,左室射血分数(LVEF)明显更低(P<0.05)。和Ⅰ~Ⅱ级组相比,Ⅲ~Ⅳ级组的LVEDV、LVESV明显更大,LVEF明显更低(P<0.05)。(3)NT-pro BNP和LVEDV(r=0.630,P<0.05)、LVESV(r=0.500,P<0.05)均为显著正相关关系,和左心室射血分数(r=-0.619,P<0.05)为显著负相关关系。结论血清NT-pro BNP能够有效地诊断老年慢性心力衰竭患者的病情程度,为临床治疗提供可靠的依据。

Objective To explore the clinical significance of serum N-terminal pro-brain natriuretic peptide （NT-proBNP） level in elderly patients with chronic heart failure. Methods 45 cases of elderly patients with chronic heart failure admitted to our hospital from January 2015 to January 2016 were selected; According to the NYHA classification, all patients were divided into stageⅠ-Ⅱgroup （20 cases） and stage Ⅲ-Ⅳ group （25 cases）. Another 45 cases of healthy person with physical examination at the same period were selected as control group. Enzyme-linked immunosorbent assay was used to detect the cardiac troponin I （CTNI） and NT-proBNP, and ultrasound diagnostic apparatus was used to detect the left ventricular function. The levels of CTNI, NT-proBNP and left ventricular function indicators were compared among three groups, and the relationships between NT-proBNP and left ventricular function indicators were analyzed. Results （1）Compared with control group, both stage Ⅰ-Ⅱ group and stage Ⅲ-Ⅳ group had significantly higher CTNI and NT-proBNP levels （P〈0.05）; Compared with stage Ⅰ-Ⅱ group, stage Ⅲ-Ⅳ group had significantly higher CTNI and NT-proBNP levels （P〈0.05）. （2）Compared with control group, both stage Ⅰ-Ⅱ group and stage Ⅲ-Ⅳ group had significantly higher left ventricular end diastolic volume （LVEDV） and left ventricular end systolic volume （LVESV）, and significantly lower left ventricular ejection fraction （LVEF）, with statistical differences （P〈0.05）; Compared with stage Ⅰ-Ⅱ group, stage Ⅲ-Ⅳ group had significantly higher LVEDV and LVESV, and significantly lower LVEF （P〈0.05）. （3）NT-proBNP was positively correlated with LVEDV （r = 0.630, P〈0.05） and LVESV （r = 0.500, P〈0.05）, and negatively correlated with LVEF （r = -0.619, P〈0.05）. Conclusions Serum NT-proBNP can effectively diagnose the severity of disease of elderly patients with chronic heart failure, which provides reliable basis for clinical treatment.