摘要
目的探讨血浆N末端B型脑钠肽前体(NT-proBNP)和中区心房利钠肽前体(MR-proANP)水平在射血分数保留的心力衰竭(HFpEF)与射血分数降低的心力衰竭(HFrEF)的患者中的作用。方法选取2014年10月至2017年10月在重庆医科大学附属第二医院心血管内科住院的患者168例为心力衰竭组,其中HFrEF患者68例(HFrEF组),HFpEF患者100例(HFpEF组),选取临床特征匹配的非心力衰竭患者64例为对照组。检测各组患者血浆MR-proANP水平及NT-proBNP水平。结果与对照组比较,HFpEF组、HFrEF组血浆MR-proANP水平均升高(P<0.05)。在HFrEF组中,血浆NT-proBNP水平与左心室射血分数呈负相关,与左心室舒张末期内径、左心室质量指数呈正相关;血浆MR-proANP水平与左心房最大内径(LAD)、左心房容积指数(LAVI)呈正相关。在HFpEF组,血浆NT-proBNP水平与LAVI呈正相关,血浆MR-proANP水平与LAD、LAVI、二尖瓣舒张早期血流速度峰值/二尖瓣舒张早期运动速度峰值呈正相关。血浆NT-proBNP水平与血浆MR-proANP水平比值最能区分HFpEF组、HFrEF组患者(曲线下面积为0.861)。在HFpEF组中,血浆MR-proANP水平是全因死亡或因心力衰竭再次住院的独立预测因子,但血浆MR-proANP水平不是HFrEF组终点事件的独立预测因子。血浆NT-proBNP水平在两组心力衰竭患者中具有相似的预测价值。结论血浆MR-proANP水平是心房容积、压力负荷增加的标志物,与血浆NT-proBNP水平联合应用具有额外的诊断价值,并且在HFpEF患者中有重要的预测价值。
Objective To investigate the levels of plasma N-terminal precursor B-type brain natriuretic peptide(NT-proBNP)and midregional atrial natriuretic peptide precursor(MR-proANP)in heart failure with preserved ejection fraction(HFpEF)and heart failure with reduced ejection fraction failure(HFrEF)in patients.Methods A total of 168 patients who were hospitalized in the department of cardiology medicine of the Second Affiliated Hospital of Chongqing Medical University from October 2014 to October 2017 were selected as the research subjects,including 68 patients with HFrEF(HFrEF group)and 100 patients with HFpEF(HFpEF group).A total of 64 non-heart failure patients as control group matched by clinical characteristics.The plasma levels of MR-proANP and NT-proBNP were detected in each group.Results Compared with the control group,the plasma MR-proANP levels in the HFpEF group and the HFrEF group were increased(P<0.05).In HFrEF group,plasma NT-proBNP level was negatively correlated with left ventricular ejection fraction,and positively correlated with left ventricular end-diastolic diameter and left ventricular mass index;plasma MR-proANP levels were positively correlated with the largest left atrial diameter(LAD)and left atrial volume index(LAVI).In the HFpEF group,plasma NT-proBNP levels were positively correlated with LAVI,and plasma MR-proANP levels were positively correlated with LAD,LAVI,peak early mitral diastolic blood flow velocity/peak mitral value velocity in early diastole.The ratio of plasma NT-proBNP level to plasma MR-proANP level was the best for differentiating patients between HFpEF group and HFrEF group(the area under the curve was 0.861).In the HFpEF group,plasma MR-proANP levels were an independent predictor of all-cause death or readmission for heart failure,but plasma MR-proANP levels were not an independent predictor of endpoint events in the HFrEF group.Plasma NT-proBNP levels had similar predictive value in two groups of heart failure patients.Conclusion Plasma MR-proANP level is a marker of increas
作者
左易霞
徐燕萍
崔坤
陈芸霖
陈剑飞
范晋奇
ZUO Yixia;XU Yanping;CUI Kun;CHEN Yunlin;CHEN Jianfei;FAN Jinqi(Department of Cardiology,Banan District People′s Hospital,Chongqing 401320,China;Department of Cardiology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Department of Cardiology,Chongqing People′s Hospital,Chongqing 400010,China)
出处
《检验医学与临床》
CAS
2022年第17期2352-2357,共6页
Laboratory Medicine and Clinic
基金
重庆市卫生健康委员会医学科研项目(2015MSXM020)。
关键词
心力衰竭
N末端B型脑钠肽前体
中区心房利钠肽
射血分数
heart failure
N-terminal precursor B-type brain natriuretic peptide
midregional atrial natriuretic peptide precursor
ejection fraction
