老年慢性充血性心力衰竭患者血NT-proBNP水平与心功能、心室重构相关性研究

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摘要目的探讨老年慢性充血性心力衰竭（CHF）患者血N 端B 型脑利钠肽前体（NT-proBNP）水平与心功能、心室重构各项指标的相关性。方法选取2018年1月～2020年12月在新余市中医院住院治疗的80 例老年（年龄≥65 岁）CHF 患者作为研究对象。比较不同纽约心脏病协会（NYHA）分级患者血NT-proBNP 水平及左室舒张末期内径（LVEDD）、左室射血分数（LVEF）、左室质量指数（LVMI）及室间隔厚度（IVST）；NT-proBNP 水平与NYHA 分级的相关性分析采用Spearman 秩相关分析，与CHF 患者LVEDD、LVEF、LVMI 及IVST 的相关性分析采用Pearson 相关分析。结果心功能Ⅳ级组患者的血NT-proBNP 水平、LVEDD、LVMI 及IVST 高于心功能Ⅲ级组、心功能Ⅱ级组、心功能Ⅰ级组，LVEF 低于心功能Ⅲ级组、心功能Ⅱ级组、心功能Ⅰ级组，差异有统计学意义（P＜0.05）；心功能Ⅲ级组患者的血NT-proBNP 水平、LVEDD、LVMI 及IVST 高于心功能Ⅱ级组、心功能Ⅰ级组，LVEF 低于心功能Ⅱ级组、心功能Ⅰ级组，差异有统计学意义（P＜0.05）；心功能Ⅱ级组患者的血NT-proBNP 水平、LVEDD、LVMI及IVST 高于心功能Ⅰ级组，LVEF 低于心功能Ⅰ级组，差异均有统计学意义（P＜0.05）。 Pearson 相关分析结果显示，血清NT-proBNP 水平与CHF 患者LVEDD、LVMI 及IVST 均呈正相关（r=0.603、0.310、0.295，P＜0.05），与LVEF呈负相关（r=-0.612，P＜0.05）；Spearman 秩相关分析结果显示，CHF 患者血清NT-proBNP 水平与NYHA 分级呈正相关（r=0.553，P＜0.05）。结论老年CHF 患者血NT-proBNP 水平与心功能及心室重构密切相关，可作为评估CHF患者心功能、心肌重构及治疗CHF 的重要参考指标。

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	张博成
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	胡绍育

关键词 ：心力衰竭, 血N 端脑利钠肽前体, 心功能, 心室重构

Abstract：Objective To investigate the correlation between serum level of N-terminal pro B type natriuretic peptide(NT-proBNP) and cardiac function and ventricular remodeling in elderly patients with chronic congestive heart failure(CHF). Methods A total of 80 elderly patients (≥65 years old) with CHF who were hospitalized in Xinyu Traditional Chinese Medicine Hospital from January 2018 to December 2020 were selected as the research objects. Serum levels of NT-proBNP, left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI) and interventricular septal thickness (IVST) were compared in patients with different New York Heart Association (NYHA) classification. Spearman rank correlation was used to analyze the correlation between serum levels of NT-proBNP and NYHA classification, meanwhile Pearson correlation was used to analyze the correlation between serum levels of NT-proBNP and LVEDD, LVEF, LVMI and IVST. Results The serum NT-proBNP level,LVEDD, LVMI and IVST of patients in cardiac function group Ⅳwere higher than those in cardiac function group Ⅲ,cardiac function group Ⅱand cardiac function group Ⅰ,while LVEF was lower than that in cardiac function group Ⅲ, cardiac function group Ⅱand cardiac function group Ⅰ, the differences were statistically significant (P＜0.05). The serum NT-proBNP level, LVEDD, LVMI and IVST of patients in cardiac function group Ⅲwere higher than those in cardiac function group Ⅱand cardiac function groupⅠ, while LVEF was lower than that in cardiac function group Ⅱand cardiac function group Ⅰ, the differences were statistically significant (P＜0.05). The serum NT-proBNP level, LVEDD, LVMI and IVST of patients in cardiac function group Ⅱwere higher than those in cardiac function group Ⅰ, while LVEF was lower than that in cardiac function group Ⅰ, the differences were statistically significant (P＜0.05). Pearson correlation analysis showed that serum NTproBNP levels were positively correlated with LVEDD, LVMI and IVST in CHF patients (r=0.603, 0.310, 0.295, P＜0.05), and negatively correlated with LVEF (r=-0.612, P＜0.05). Spearman rank correlation analysis showed that serum NT-proBNP level in CHF patients was positively correlated with NYHA classification (r=0.553, P＜0.05). Conclusion Serum level of NT-proBNP is significantly correlated with cardiac function and ventricular remodeling in elderly patients with CHF, and can be used as an important reference index for evaluating the cardiac function, myocardial remodeling and treatment of patients with CHF.

Key words： Heart failure Serum N-terminal pro-brain natriuretic peptide Cardiac function Ventricular remodeling

收稿日期: 2021-01-28

基金资助:江西省卫生健康委科技计划项目（20204509）

作者简介: 张博成（1973-），男，汉族，江西新余人，硕士，副主任医师，研究方向：心脑血管疾病

引用本文:

张博成；章小稳；龚艳青；张宝钧；胡绍育. 老年慢性充血性心力衰竭患者血NT-proBNP水平与心功能、心室重构相关性研究[J]. 中国当代医药, 2021, 28(12): 8-011.
ZHANG Bo-cheng；ZHANG Xiao-wen；GONG Yan-qing；ZHANG Bao-jun；HU Shao-yu. Research on the correlation between serum level of NT-proBNP and cardiac function and ventricular remodeling in elderly patients with chronic congestive heart failure. 中国当代医药, 2021, 28(12): 8-011.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I12/8

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