摘要
目的探讨血浆氨基末端脑钠肽(NT-proBNP)、超敏C反应蛋白(hs-CRP)水平及超声心动图指标的相关性及对慢性心力衰竭(CHF)的诊断价值。方法选取2015年12月—2017年6月收治的CHF 120例为研究组,选取同期进行体检的健康者45例作为对照组,根据左心室射血分数(LVEF)水平分为LVEF正常组(LVEF≥50%) 54例和LVEF降低组(LVEF <50%) 66例。检测各组心室舒张早期二尖瓣瓣口最大血流速度与心室舒张晚期二尖瓣瓣口最大血流速度比值(E/A)、LVEF、hs-CRP、NT-proBNP以及美国心脏病学会(NYHA)分级,探讨NT-proBNP、hs-CRP水平及超声心动图指标间的相关性。结果研究组LVEF、E/A低于对照组,hs-CRP及NT-proBNP水平高于对照组(P <0. 05,P <0. 01)。NYHAⅣ级患者NT-proBNP及hs-CRP水平高于NYHAⅢ级和Ⅱ级,且NYHAⅢ级高于Ⅱ级(P <0. 05)。不同心功能分级患者E/A比较差异无统计学意义(P> 0. 05),LVEF随心功能分级的增加而逐渐降低(P <0. 05)。LVEF降低组NT-proBNP和hs-CRP水平高于LVEF正常组(P <0. 05)。NT-proBNP和hs-CRP与LVEF均呈负相关(r=-0. 682、-0. 529,P <0. 01)。结论 NT-proBNP、hs-CRP水平、LVEF、E/A均可辅助诊断CHF,NT-proBNP和hs-CRP水平均与LVEF呈负相关,联合检测对CHF的早期诊断及治疗有重要意义。
Objective To investigate correlations among plasma N-terminal pro-brain natriuretic peptide （NT- proBNP） level, high sensitivity- C-reactive protein （hs-CRP） level and echocardiographic indexes and their value in di- agnosis of patients with chronic heart failure （ CHF）. Methods A total of 120 CHF patients admitted during December 2015 and June 2017 were selected as research group, and other 45 healthy people taking medical examination at the same period were selected as control group. The patients were divided into normal left ventricular ejection fraction （LVEF） subgroup （ u = 54, LVEF ≥50% ） and decreased LVEF subgroup （ u = 66, LVEF 〈 50% ） according to LVEF values. Ratio of mitral valve orifice of peak velocity during early period of ventricular diastole to mitral valve orifice of peak veloci- ty during advanced period of ventricular diastole （E/A） , LVEF, hs-CRP, NT-proBNP and NYHA （New York Heart As- sociation） classification were detected in each group, and then correlations among NT-proBNP level, hs-CRP level and echocardiographic indexes were investigated. Results In research group, LVEF and E/A levels were significantly lower, while hs-CRP and NT-proBNP levels were significantly higher than those in control group （ P 〈 0.05, P 〈 0.01 ）. NT-proBNP and hs-CRP levels in patients with NYHA IV were significantly higher than those in patients with NYHA Ⅲ and Ⅱ , and the levels in patients with NYHA Ⅲ were significantly higher than those in patients with NYHA Ⅱ （P 〈 0.05）. There were no significant differences in E/A values among patients with different NYHA classifications （P 〉 0.05） , and LVEF value was gradually decreased with increasing cardiac function classification （P 〈 0.05, P 〈 0.01 ）.NT-proBNP and hs-CRP levels in decreased LVEF subgroup were significantly higher than those in normal LVEF sub- group （P 〈 0.05）. NT-proBNP and hs-CRP showed negatively correlated with LVEF （ r = - 0. 682 and - 0. 529, P 〈 0.01）. Conclus
作者
田艳珍
崔继婷
赵金芳
左晓霞
王汉伟
牛炳英
TIAN Yan-zhen1 , CUI Ji-ting1 , ZHAO Jin-fang1 , ZUO Xiao-xia1 , WANG Han-wei2 , NIU Bing-ying3(1. The First De- partment of Cardiology, the First Hospital of Zhangjiakou, Zhangjiakou, Hebei 075000, China; 2. Department of Osteology, the Second Hospital of Zhangjiakou, Zhangjiakou, Hebei 075000, China; 3. Department of Cardiology, People Hospital of Luquan, Shijiazhuang 050200, China)
出处
《解放军医药杂志》
CAS
2018年第10期43-46,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
河北省卫生和计划生育委员会科技计划项目(20171041)
关键词
慢性心力衰竭
血浆氨基末端脑钠肽
超敏C反应蛋白
超声心动图指标
Chronic heart failure
N-terminal pro-brain natriuretie peptide
High sensitivity-C-reactive protein
Eehoeardiography index
