射血分数保留心力衰竭患者检测N-末端脑钠肽前体及脂蛋白相关磷脂酶A2的意义

The Significance of Detection of Plasma NT-proBNP and Lp-PLA2 Levels in Heart Failure with Preserved Ejection Fraction Patients

目的:研究射血分数保留心力衰竭(HFpEF)患者检测N-末端脑钠肽前体(NT-proBNP)及脂蛋白相关磷脂酶A2(Lp-PLA2)的意义。方法:选取2016年1月-2018年10月本院初次收治的射血分数保留心力衰竭患者101例为研究组,选取同期心功能正常者83例为对照组。根据NYHA分级将研究组分为NYHAⅣ级组31例,NYHA Ⅲ级组40例及NYHA Ⅱ级组30例。抽取清晨空腹静脉血,检测患者静脉血中NT-proBNP、Lp-PLA2、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)水平。比较各组一般资料、相关检测指标。分析HFpEF患者各变量与NYHA分级相关性。结果:各组HDL-C、NT-proBNP、Lp-PLA2水平比较,差异均有统计学意义(P<0.05)。NYHA Ⅳ级组的HDL-C低于NYHA Ⅲ级组和对照组(P<0.05)。NYHA Ⅳ级组、NYHA Ⅲ级组、NYHA Ⅱ级组的NT-proBNP、Lp-PLA2水平均明显高于对照组,NYHA Ⅳ级组、NYHA Ⅲ级组的NT-proBNP、Lp-PLA2水平均明显高于NYHA Ⅱ级组,NYHA Ⅳ级组的NT-proBNP、Lp-PLA2水平均明显高于NYHA Ⅲ级组,差异均有统计学意义(P<0.05)。HFpEF患者血NT-proBNP水平、血Lp-PLA2水平均与NYHA分级呈正相关(P<0.001);HDL-C水平与NYHA分级无明显相关性(P>0.05)。结论:HFpEF患者血NT-proBNP水平、血Lp-PLA2水平均明显升高,且与心功能NYHA分级呈正相关,为射血分数保留心力衰竭的诊断和严重程度判断提供新的依据。

Objective:To study the significance of detecting N-terminal pro-B-type natriuretic peptide (NT-proBNP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) in heart failure with preserved ejection fraction (HFpEF) patients.Method:A total of 101 patients with HFpEF initially admitted to our hospital from January 2016 to October 2018 were selected as the research group.83 patients with normal cardiac function were selected as the control group.According to the NYHA classification,the research group was divided into NYHA Ⅳ group of 31 cases,NYHA Ⅲ group of 40 cases and NYHA Ⅱ group 30 cases.Take the morning fasting venous blood,the levels of NT-proBNP,Lp-PLA2,low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were detected.The general data and relevant test indicators of each group were compared.The correlation between each variable of HFpEF patients and NYHA classification was analyzed.Result:HDL-C,NT-proBNP and Lp-PLA2 levels of each group were compared,the differences were statistically significant (P<0.05).HDL-C of NYHA Ⅳ level group was lower than those of NYHA Ⅲ group and control group (P<0.05).The levels of NT-proBNP and Lp-PLA2 in NYHA Ⅳ group,NYHA Ⅲ group and NYHA Ⅱ group were significantly higher than those in the control group,the levels of NT-proBNP and Lp-PLA2 in NYHA Ⅳ group and NYHA Ⅲ groups were significantly higher than those in NYHA Ⅱ group,the levels of NT-proBNP and Lp-PLA2 in NYHA Ⅳ group were significantly higher than those in NYHA Ⅲ group,the difference were statistically significant (P<0.05).The levels of NT-proBNP and Lp-PLA2 were positively correlated with NYHA class (P<0.001).There was no significant correlation between the proportion of HDL-C and NYHA class (P>0.05).Conclusion:The level of NT-proBNP and Lp-PLA2 in the blood of HFpEF patients are significantly increased and positively correlated with NYHA grade of cardiac function,which can provide a new basis for the diagnosis and severity judgment of HFpEF.