摘要
目的:评价心力衰竭患者血浆氨基端脑钠素原(NT-proBNP)与有创血流动力学监测指标的相关性。方法:选择心力衰竭患者纽约心功能分级(NYHA)Ⅱ-Ⅳ级89例,在入院12 h 内行漂浮导管监测,同时采用酶联免疫吸附(ELISA)方法检测血浆 NT-proBNP。比较有创血流动力学指标在不同血浆 NT-proBNP 水平时的变化,比较血浆NT-proBNP、左心室舒张末内径和左心室射血分数在不同肺动脉楔压水平时的变化,同时探讨血浆 NT-proBNP 与肺动脉楔压的相关性。结果:89例患者有创血流动力学指标在不同血浆 NT-proBNP 水平的变化比较:血浆 NT-proBNP 水平>600者与≤600者比较,右心房压、右心室压、肺动脉压、肺动脉楔压、肺循环阻力均明显升高,差异均有统计学意义(P<0.05～0.01)。89例患者不同血浆 NT-proBNP 水平间肺动脉楔压、左心室舒张末内径和左心室射血分数比较:肺动脉楔压:与血浆 NT-proBNP 水平≤600者比较,其它血浆 NT-proBNP 水平者均显著增高,差异均有统计学意义(P 均<0.01)。左心室舒张末内径:仅3600≥NT-proBNP>2601者较≤600者明显升高,差异有统计学意义(P<0,05)。左心室射血分数:仅血浆 NT-proBNP>3601者较≤600者明显降低,差异有统计学意义(P<0.05)。89例患者不同肺动脉楔压等级间血浆NT-proBNP 水平、左心室舒张末内径和左心室射血分数的比较:血浆 NT-proBNP 水平:与肺动脉楔压<18有比较,其它等级肺动脉楔压者均明显升高,差异均有统计学意义(P 均<0.01);左心室舒张末内径:与肺动脉楔压<18者比较仪38>肺动脉楔压≥28者明显升高,差异有统计学意义(P<0.01);左心室射血分数:与肺动脉楔压<18者比较,肺动脉楔压≥18者、38>肺动脉楔压≥28者、肺动脉楔压≥38者均明显降低,差异均有统计学意义(P<0.05～0.01)。在校正了各种影响因素后,肺动脉楔压与 NT-proBNP 显著相关;多元线性回归分析也表明 NT-proBNP 与肺动脉楔压�
Objective：To explore the correlation between plasma N-terminal proBNP fragment（NT-proBNP） and invasive hemodynamic monitoring parameters in patients with heart failure. Methods：A total of 89 patients with heart failure （by New York Heart Association （NYHA）class Ⅱ-Ⅳ ）were performed with Swan-Ganz catheter within 12 hours after hospital admission. At the same time ,plasma NT-proBNP was measured by ELISA method. Result：The changes of invasive hemodynamic monitoring result at different level of plasma NT-proBNP were compared in 89 patients. The differences of pulmonary capillary wedge pressure（ PCWP）, right atrial pressure, right ventricular pressure and pulmonary arterial pressure were statistically significant between NT-proBNP 〉 600 and NT-proBNP ≤〈 600 fmol/1 groups （P 〈 0. 05 - 0.01 ）. The difference of NT-proBNP were statistically significant between PCWP ≥18 and PCWP 〈 18 mmHg groups（ 1356.49 vs 2861.83 fmol/1, P 〈 0. 001 ）. NT-proBNP correlated well with PCWP after adjustment of age, sex, body mass index, blood pressure,left ventricular end diastolic dimension,left ventricular ejection fraction, creatinine, blood urea nitrogen and NYHA classificaton（ R =0.42 ,P =0. 001 ） ,but there was no correlation between the PCWP and left ventricular end diastolic dimension or left ventricular ejection fraction. The close correlation between PCWP and NT-proBNP persisted in multiple linear regression analysis （β =0. 36,P =0. 001）. Conclusion：NT-proBNP correlated well with invasive hemolodynamic parameters.
出处
《中国循环杂志》
CSCD
北大核心
2008年第4期267-270,共4页
Chinese Circulation Journal
