血浆NT-proBNP水平在慢性心衰中的诊断及预后评估

Diagnosis and prognostic evaluation of plasma NT-proBNP level in chronic heart failure

目的研究分析血浆N末端B型利钠肽原(NT-proBNP)水平在慢性心力衰竭(心衰)中的诊断及预后评估效果。方法130例慢性心衰患者,根据美国纽约心脏病协会(NYHA)分级对患者进行分级,Ⅰ~Ⅱ级的患者划为A组(84例),Ⅲ~Ⅳ级患者划分为B组(46例)。比较不同NYHA分级患者血浆NT-proBNP、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)水平以及A、B组患者肾功能、血脂、并发症和死亡发生情况。结果NYHA分级提高,患者血浆NT-proBNP、LVEDD水平均逐渐升高,LVEF水平逐渐降低,比较差异均具有统计学意义(P<0.05)。A组患者尿素氮(5.87±2.41)μmol/L、肌酐(76.15±23.01)μmol/L均低于B组的(12.32±6.75)、(95.09±31.81)μmol/L,胆固醇(4.61±1.61)mmol/L、高密度脂蛋白胆固醇(1.41±0.56)mmol/L、低密度脂蛋白胆固醇(3.25±0.79)mmol/L均高于B组的(3.26±0.94)、(1.11±0.32)、(2.51±0.61)mmol/L,差异具有统计学意义(P<0.05)。A组患者并发症发生率15.48%、死亡率0均低于B组的30.43%、6.52%,差异具有统计学意义(P<0.05)。结论血浆NTproBNP可以有效反映慢性心衰患者左心室的多项功能数据,在对慢性心衰的诊断和治疗以及预后评估中有着相当重要的临床使用价值。

Objective To study and analyze the diagnosis and prognostic evaluation effect of plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP)level in chronic heart failure.Methods A total of 130 chronic heart failure were divided into group A(Ⅰ-Ⅱgrades,84 cases)and group B(Ⅲ-Ⅳgrades,46 cases)according to New York Heart Association(NYHA)grading.The plasma NT-proBNP,left ventricular ejection fraction(LVEF),left-ventricular end-diastolic diameter(LVEDD)of patients with different NYHA grades.The renal function,blood lipids,occurrence of complications and death were compared between the two groups.Results The levels of plasma NT-proBNP and LVEDD were gradually increased and LVEF level was gradually decreased with the increase of NYHA grade,and the difference was statistically significant(P<0.05).The urea nitrogen rea nitrogen and creatinine(76.15±23.01)μmol/L of group A was lower than that of the control group(12.32±6.75)and(95.09±31.81)μmol/L,and cholesterol(4.61±1.61)mmol/L,high-density lipoprotein cholesterol(1.41±0.56)mmol/L,low-density lipoprotein cholesterol(3.25±0.79)mmol/L was higher than that of group B(3.26±0.94),(1.11±0.32),(2.51±0.61)mmol/L,and the difference was statistically significant(P<0.05).The incidence of complications 15.48%and death rate 0 of group A was lower than that of group B 30.43%and 6.52%,and the difference was statistically significant(P<0.05).Conclusion Plasma NT-proBNP can effectively reflect the left-ventricular function data of patients with chronic heart failure.It is of great clinical value in the diagnosis,treatment and prognosis evaluation of chronic heart failure.