血清NT-proBNP水平对急性脑梗死患者左心室舒张功能损伤程度的临床诊断价值

Diagnostic value of serum NT-proBNP level on left ventricular diastolic function damage degree in patients with acute cerebral infarction

目的:探讨急性脑梗死患者氨基末端B型脑利钠肽前体(NT-proBNP)与左心室等容舒张时间(IVRT)和二尖瓣环舒张早期心肌峰值运动速度/二尖瓣环舒张晚期心肌峰值运动速度(Ea/Aa)的相关性。方法:选择2015-02~2016-05我院收治的急性脑梗死患者67例为观察组,同期选择体检健康者60例为对照组。测定两组血清NT-proBNP水平和心脏超声参数;对NT-proBNP与左心室舒张功能进行相关性分析,并用ROC曲线分析NT-proBNP评估左心室舒张功能的价值。结果:与对照组相比,观察组的IVRT和NT-proBNP显著提高(P<0.01),而Ea/Aa降低(P<0.05)。Spearman相关分析显示,NT-proBNP与IVRT呈显著正相关(r=0.507,P<0.01),与Ea/Aa呈显著负相关(r=-0.592,P<0.01)。多元线性回归分析提示,NT-proBNP与IVRT、Ea/Aa独立相关(标准化β=541.90、26.38)。ROC预测结果显示,NT-proBNP在检测Ea/Aa<1.0的急性脑梗死患者时具有最佳灵敏度(100%)和特异度(100%)。结论:血清NT-proBNP水平能够有效评估急性脑梗死患者的左心室舒张功能损伤程度。

Objective：To investigate the relationship of NT-proBNP and IVRT,Ea/Aa in patients with acute cerebral infarction.Methods：Sixty-seven patients with acute cerebral infarction from February 2015 to May 2016 were selected as observation group,and 60 healthy subjects were selected as control group.The serum NT-proBNP levels and cardiac ultrasound parameters of the two groups were measured.The correlation between NT-proBNP and left ventricular diastolic function was analyzed,and the value of NT-proBNP in assessing left ventricular diastolic function was evaluated by ROC curve.Results：Compared with the control group,the IVRT and NT-proBNP of observation group were significantly increased（P 0.01）,while Ea/Aa was lower（P0.05）.There was a significant positive correlation between NT-proBNP and IVRT（r=0.507,P0.01）,and a remarkable negative correlation between NT-proBNP and Ea/Aa（r=-0.592,P0.01）.Multiple linear regression analysis showed that NT-proBNP was independently correlated with IVRT and Ea/Aa（β=541.90,26.38）.Conclusion：Serum NT-proBNP levels can indirectly reflect the severity of left ventricular diastolic dysfunction in patients with acute cerebral infarction.