酒精性肝硬化心肌病患者Tei指数与血浆BNP的相关性研究

Correlation between B-type natriuretic peptide and Tei index in patients with alcoholic cirrhosis cardiomypathy

目的探讨酒精性肝硬化心肌病(ACCM)患者心肌综合指数(Tei指数)与血浆脑钠肽(BNP)的相关性:方法选取河北北方学院附属第一医院收治的40例ACCM患者作为观察组,另选取同期健康志愿者40例作为正常组。应用ELISA法检测2组血浆BNP水平,并行彩色超声多普勒检测,测量左心室收缩末期内径(LVESd)和舒张末期内径(LVEDd)、室间隔厚度(LVSd)和左心室射血分数(LVEF),计算Tei指数,分析血浆BNP水平、Tei指数与心脏各指标的相关性.结果观察组的LVESd,LVEDd,Tei指数明显高于正常组,而LVSd和LVEF值低于正常组,差异有统计学意义(P均<0.05).Tei指数与LVEF呈负相关,而与LVEDd呈正相关(P均<0.05)。血浆BNP水平与Tei指数、LVEDd呈正相关,而与LVEF呈负相关(P均<0.05)。多元回归分析结果显示,进入BNP逐步回归方程的变量为Tei指数,LVEDd、LVEF;校正LVEF后,符合变量的仅为Tei指数(P<0.01).结论ACCM患者的Tei指数与血浆BNP水平呈一致性,二者可相互弥补,为整体评估、监测心功能提供科学参考。

Objective To explore the relationship between Tei index and the level of B - type natriuretic peptide (BNP) in patients with alcoholic cirrhosis cardiomyopathy ( ACCM). Methods A total of 40 ACCM patients who were admitted into the First Affiliated Hospital of Hebei North University were selected and set as an observation group. Meanwhile ,another 40 healthy volunteers were selected as a normal group. Their levels of plasma BNP were detected by ELISA. Then, color doppler imaging was performed to measure left ventricular end - diastolic diameter ( LVEDd), left ventricular end - systolic diameter ( LVESd), interventricukir septal thickness at diastole ( LVSd), left ventricular ejection fraction( LVEF) and Tei index, so as to calculate Tei index. The correlation between Tei index, plasma BNP level, and cardiac indicators was analyzed. Results Compared with the normal group, the obserxation group showed remarkable increases in LVESd, LVEDd and Tei index and marked decreases in LVSd and LVEF (P <0. 05). Tei irulex was negatively correlated with LVEF and positively correlated with LVEDd (P < 0. 05 ). The level of plasma BNP was positively correlated with LVEF and negatively correlated with Tei index and LVEDd ( P <0. 05 ). According to multiple regression analysis, the variables used in BNP stepwise regression equation were Tei index, LVEF and LVEDd, and only Tei index was used after LVEF correction ( P <0. 01). Conclusions For ACCM patients, their Tei index was obviously associated and plasma BNP level.