血浆N末端脑利钠肽水平和心脏超声功能参数在评估临床心功能分级中的价值研究

目的探讨血浆N末端脑利钠肽(NT-proBNP)水平和心脏超声功能参数在评估临床心功能分级中的价值.方法选取慢性心力衰竭患者106例,入院次日清晨抽取患者空腹肘静脉血,采用酶联免疫法检测血浆NTproBNP水平,并对患者进行纽约心脏病协会(NYHA)心功能分级评定,之后进行心脏彩色多普勒超声检查.结果血浆NT-proBNP水平与心功能分级之间呈明显正相关(P0.01);左心室短轴缩短率、左心射血分数与心功能分级之间呈明显负相关(P0.01);左心室舒张末期内径、左心室收缩末期内径与心功能分级之间呈明显正相关(P0.01);不同心功能分级之间血浆NT-proBNP水平、各心脏超声功能参数均存在明显差异(P0.01);其中,心功能Ⅰ级和Ⅱ级,Ⅲ级和Ⅳ级之间差异均无统计学意义(P0.05),Ⅲ级与Ⅰ级、Ⅱ级,Ⅳ级与Ⅰ级、Ⅱ级之间差异均有显著统计学意义(P0.01);NT-proBNP联合心脏超声检查对不同心功能分级的诊断特异性和敏感性明显高于血浆NT-proBNP水平、心脏超声检查,差异具有统计学意义(P0.05).结论血浆NT-proBNP水平联合心脏超声功能参数能够客观准确地判断慢性心力衰竭患者的心功能情况,有助于指导临床对该类患者的治疗及判断预后.

Values of NT-proBNP Level and Cardiac Ultrasound Function Parameters in Evaluating Clinical Heart Function Classification

Objective To investigate the value of NT-proBNP level and cardiac ultrasound function parameters in evaluating clinical heart function classification. Method A total of 106 chronic heart failure ( CHF) patients evaluating were enrolled. Fasting elbow venous blood was collected in the next morning after admission,and the NT-proBNP plasma level was detected by enzyme linked immunosorbent assay. Cardiac function of the patient was graded according to New York Heart Association ( NYHA ) , afterwards, the patient would undergo heart color Doppler ultrasonography. Results Relations between the level of plasma NT-proBNP and heart function classification showed a positive correlation (P<0. 01). The left ventricular shortening fraction,left ventricular ejection fraction and cardiac functional grading were negatively correlated with left ventricular diastolic (P<0. 01). There was a significant positive correlation between end systolic diameter, left ventricular end systolic diameter and heart function classification ( P<0 . 01 ) . The plasma NT-proBNP level and the cardiac ultrasound function parameters between different cardiac function grades had obvious differences ( P<0 . 01 ) . The differences between grade I and II,between III and IV showed no statistical significance (P>0. 05);grade III and grade I,II,grade IV and grade I,II were statistically significant (P<0. 01). The sensitivity and specificity of cardiac function grading diagnosis according to NT-proBNP level combined with cardiac ultrasonography were significantly higher than NT-proBNP level or cardiac ultrasonography (P<0. 05). Conclusion Plasma NT-proBNP level combined with cardiac function parameters of ultrasonic can objectively and accurately judge the heart function of patients with chronic heart failure,which is helpful in guiding clinical treatment and judging prognosis.