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目的探讨慢性心衰患者血清脑利钠肽前体(NT-proBNP)水平与不同NYHA心功能分级、左室射血分数(LVEF)、左室舒张期末内径(LVEDd)的相关性。方法 42例心力衰竭住院患者,使用酶联免疫法测定其血清NT-proBNP水平,超声心动图测定LVEF及LVEDd,分析患者NT-proBNP水平与不同心功能分级及上述指标的相关性。结果 (1)不同NYHA心功能分级组患者血清NT-proBNP水平(pg/ml)差异有统计学意义[Ⅰ级:162.5(128.0,633.0),Ⅱ级:1 202.5(587.0,2350.0),Ⅲ级:3 374.0(2 169.0,4 442.0),Ⅳ:10 403.5(7 241.0,17 697.0),P<0.05~<0.01],其水平与心功能分级呈正相关(r=0.797,P<0.000 1);(2)NT-proBNP与LVEF呈负相关(r=-0.438,P<0.000 1);(3)NT-proBNP与LVEDd呈正相关(r=0.437,P<0.000 1)。结论 NT-proBNP测定是临床诊断心力衰竭的有效辅助方法之一,总体上可反映心力衰竭的严重程度。
Objective To investigate the correlation between serum brain natriuretic peptide precursor (NT-proBNP) levels and NYHA functional class, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDd) in patients with chronic heart failure. Methods Forty-two inpatients with heart failure were enrolled in this study. Serum NT-proBNP level was measured by enzyme-linked immunosorbent assay. LVEF and LVEDd were measured by echocardiography. The correlation between NT-proBNP level and cardiac function classification and the above indexes were analyzed. Results (1) The levels of serum NT-proBNP (pg / ml) in patients with NYHA functional class were significantly different (grade Ⅰ: 162.5 (128.0,633.0), grade Ⅱ: 1 202.5 (587.0,2350.0), grade Ⅲ (P <0.0001); 3 374.0 (2 169.0,4 442.0), Ⅳ: 10 403.5 (7 241.0,17 697.0), P <0.05 ~ <0.01] (2) There was a negative correlation between NT-proBNP and LVEF (r = -0.438, P <0.0001). (3) There was a positive correlation between NT-proBNP and LVEDd (r = 0.437, P <0.0001). Conclusion NT-proBNP is one of the effective methods to diagnose heart failure clinically. It can generally reflect the severity of heart failure.