老年心力衰竭患者血NT-proBNP与心功能的关系(1)
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[摘要] 目的 探讨老年心力衰竭(HF)患者血浆N-末端脑钠肽(NT-proBNP)与心力衰竭严重程度的关系，评价其对老年心力衰竭患者的临床意义。 方法 老年心力衰竭患者72例，根据纽约心脏病协会(NYHA)心功能分级，其中NYHAⅡ级26例、Ⅲ级28例、Ⅳ级18例，同时选取34例心功能正常老年人作为对照组，分别测定血浆NT-proBNP值及左室射血分数(LVEF)。 结果 老年心力衰竭组NT-proBNP数值明显高于对照组，且其数值随心功能分级的升高而增高，与LVEF呈负相关(P < 0.05)。 结论 老年心力衰竭患者血NT-proBNP水平与心力衰竭严重程度存在相关性，可客观反映老年心力衰竭患者的心功能状态。
[关键词] 老年；N-末端脑钠肽；心力衰竭；左室射血分数
[中图分类号] R541 [文献标识码] B [文章编号] 1673-9701(2012)06-0141-02
Relationship between plasma N-terminal pro-brain natriuretic peptide levels in elderly patients with heart failure
JIANG Han ZHANG Yifei LI Mingsheng ZHANG Xiaochong
Department of Cardiology, Dalian Harbor Hospital, Dalian 116001, China
[Abstract] Objective To investigate the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in elderly patients with the deterioration of the heart failure severity. Methods All of 72 elderly patiants with heat failure were selected,among them 26 cases subjects with NYHAⅡ,28 subjects with NYHA Ⅲ,18 subjects with NYHA Ⅳ), and 34 elderly subjects were enrolled in cintorl group. The plasma level of NT-proBNP were detected by electrochemiluminescence immunoassay methed,and the structure and fuction of left ventricle were examined by echocardiography. Results The plasma level of NT-proBNP increased significantly in elderly patients with heart failure compard with control groups,and the dregreed of NYHA.The levels of plasma NT-proBNP were negatively correlated with LVEF. Conclusion The plasma level of NT-proBNP has the realationship with the deterioration of the heart failure severity, and it can be used to evaluate the function in the elderly patients with heart failure.
[Key words] Elderly patients；N-terminal pro-brain natriuretic peptide (NT-proBNP)；Heart failure(HF)；LVEF
心力衰竭是老年人住院的主要原因，而老年人作为特殊群体，其述说准确性常较差，有时对诊断及心衰病情程度的判断存在影响。本文通过测定血NT-proBNP数值，探讨其与老年心力衰竭严重程度的相关性，评价其在老年心力衰竭患者病情评估中的临床意义。
1 对象与方法
1.1 研究对象
选取2009年4月～2010年4月间于我院心内科住院治疗老年心力衰竭患者72例，按纽约心脏协会(NYHA)分级：Ⅱ级26例、Ⅲ级28例、Ⅳ级18例，其中高血压心脏病患者32例，冠心病患者28例，心脏退行性瓣膜病患者12例，男性48例，女性24例，年龄66～78岁，平均年龄(73.6±5.8)岁。同时选取我院门诊健康体检老年人34例作为对照组，其中男性20例，女性14例，年龄65～77岁，平均年龄(72.4±5.5)岁。所有研究对象均除外严重肝肾功能疾病、急性冠脉病变、恶性肿瘤、严重感染及自身免疫性疾病。
1.2 检测方法
取肘静脉血2 mL，加入EDTA抗凝管中，分离血清，采用Roche411电化学全自动分析仪及其配套试剂，电化学发光法测定血浆NT-proBNP值；心脏彩色多普勒超声测定左室结构及左室射血分数(LVEF)(改良Simpson法) ......
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