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目的:评价血N-端B型钠尿肽原水平对心力衰竭的诊断价值及与心功能分级之间的相关性。方法:对122例心血管疾病患者根据NYHA心功能分级分为Ⅰ、Ⅱ、Ⅲ、Ⅳ组。同期本院体检中心健康体检者20例作为对照组。测定血N-端B型钠尿肽原浓度,心脏超声测量左室舒张末内径、左室短轴缩短率、左室射血分数等指标。其中20例患者于抗心力衰竭治疗10d后复测血N-端B型钠尿肽原浓度,进行统计学分析。结果:心力衰竭患者血N-端B型钠尿肽原浓度随NYHA分级增加而增高,且均高于对照组(P<0.01)。对照组、NYHAⅠ、Ⅱ组间的左室舒张末内径、左室短轴缩短率和左室射血分数差异无统计学意义(P>0.05)。NYHA分级与N-端B型钠尿肽原及左室舒张末内径呈正相关性,与左室短轴缩短率和左室射血分数呈负相关,其中与N-端B型钠尿肽原相关程度最高。结论:N-端B型钠尿肽原水平在心力衰竭患者中明显升高,是反映心力衰竭严重程度的指标。
OBJECTIVE: To evaluate the diagnostic value of N-terminal B-type natriuretic peptide (N-terminal pro-brain natriuretic peptide) in the diagnosis of heart failure and its correlation with the classification of cardiac function. Methods: 122 patients with cardiovascular diseases were divided into Ⅰ, Ⅱ, Ⅲ and Ⅳ groups according to NYHA functional class. In the same period, 20 cases of physical examination in our hospital were taken as control group. The concentration of N-terminal B-type natriuretic peptide, the left ventricular end-diastolic diameter, shortening of left ventricular short axis and left ventricular ejection fraction were measured. Among them, 20 patients were tested for the original concentration of N-terminal B-type natriuretic peptide after 10 days of anti-heart failure treatment for statistical analysis. Results: The concentration of N-terminal B-type natriuretic peptide in patients with heart failure increased with the increase of NYHA class, and were higher than those in the control group (P <0.01). There was no significant difference in left ventricular end-diastolic diameter, left ventricular fractional shortening and left ventricular ejection fraction between NYHA Ⅰ and Ⅱ in the control group (P> 0.05). NYHA classification and the N-terminal B-type natriuretic peptide and left ventricular end-diastolic diameter was positively correlated with left ventricular fractional shortening and left ventricular ejection fraction was negatively correlated with the N-terminal B-type natriuretic peptide Most relevant. Conclusion: The original level of N-terminal B-type natriuretic peptide is significantly elevated in patients with heart failure and is an indicator of the severity of heart failure.