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目的分析血清内N末端B型脑利钠肽(NT-proBNP)与和肽素(copeptin)水平对慢性心力衰竭(CHF)患者病情分级的临床应用价值,为CHF患者病情分级判断提供客观参考指标。方法选取北京市航空总医院2013年5月-2016年5月收治的194例CHF患者为观察组,并选取同期100名健康体检者作为对照组。检测两组受试者血清NT-proBNP、和肽素水平,观察CHF患者治疗前后上述血清指标变化及心功能差异,分析其评估患者心功能分级的临床价值。结果观察组左房内径(LAD)、左室舒张末期内径(LVEDD)、NT-proBNP及和肽素水平高于对照组,左室射血分数(LVEF)低于对照组,差异均有统计学意义(P<0.05)。随着CHF患者NYHA分级的上升,其LAD、LVEDD、NT-proBNP、和肽素逐渐上升,LVEF逐渐下降,差异有统计学意义(P<0.05)。CHF患者治疗后LAD、LVEDD、LVEF与治疗前比较,差异无统计学意义(P>0.05),其血清NT-proBNP及和肽素均较治疗前下降,差异有统计学意义(P<0.05)。Pearson相关性分析示,血清内NT-proBNP与和肽素呈正相关(r=0.626,P<0.05)。结论随着CHF患者NYHA分级的增加及心功能的下降,其血清内NT-proBNP与和肽素水平逐渐上升,监测CHF患者血清上述指标变化有望弥补心功能指标变化滞后的弊端。
Objective To analyze the clinical value of serum N-terminal NT-proBNP and copeptin levels in patients with chronic heart failure (CHF) and provide an objective reference index for the grading of CHF patients . Methods A total of 194 CHF patients admitted to Beijing Aviation General Hospital from May 2013 to May 2016 were selected as the observation group and 100 healthy subjects were selected as the control group. Serum levels of NT-proBNP and copeptin were measured in both groups. The changes of serum indexes and cardiac function before and after CHF treatment were observed. The clinical value of assessing the cardiac function classification was analyzed. Results The left atrium diameter (LAD), left ventricular end-diastolic diameter (LVEDD), NT-proBNP and copeptin levels in the observation group were significantly higher than those in the control group and the left ventricular ejection fraction (LVEF) was lower than that in the control group Significance (P <0.05). With the rise of NYHA classification in CHF patients, the LAD, LVEDD, NT-proBNP and Copeptin gradually increased, and the LVEF decreased gradually with statistical significance (P <0.05). The serum levels of NT-proBNP and copeptin in CHF patients after treatment were significantly lower than those before treatment (P <0.05), but there was no significant difference in LAD, LVEDD and LVEF between before and after treatment (P> 0.05) . Pearson correlation analysis showed that there was a positive correlation between serum NT-proBNP and copeptin (r = 0.626, P <0.05). Conclusions With the increase of NYHA grade and decline of cardiac function in CHF patients, the levels of NT-proBNP and Copeptin in serum gradually increase. It is expected that the changes of above indexes in serum of CHF patients will make up for the lag of cardiac function indexes.