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目的探讨心力衰竭(HF)患者血清N端B型脑钠肽前体(NT-proBNP)改变及其临床意义。方法采用双向侧流免疫方法测定107例HF(NYHAⅠ、Ⅱ、Ⅲ、Ⅳ)患者、30例健康对照者及28例HF患者经常规抗心衰治疗后3、7、15d血清NT-proBNP水平,并进行统计分析。结果(1)血清NT-proBNP水平在心力衰竭组不同NYHA级明显高于健康对照组,且血清NT-proBNP水平随着心力衰竭程度加重而增加;(2)不同心血管疾病所致心衰患者的血清NT-proBNP水平不尽相同,急性心肌梗死患者组血清NT-proBNP水平显著高于其他心血管病组,未发生急性心梗的冠心病和高血压心脏病患者组血清NT-proBNP水平最低;(3)患者治疗后第3d、第7d、第15d其血清NT-proBNP的浓度水平逐渐下降,且与临床情况的改善相对应,治疗后3个时间点与治疗前比较NT-proBNP浓度的变化幅度与NY-HA分级的变化幅度呈正相关。结论血清NT-proBNP水平是反映心功能状态的强有力的客观指标,对HF的诊断、严重程度和疗效评价有重要价值。
Objective To investigate the changes of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with heart failure (HF) and its clinical significance. Methods The levels of serum NT-proBNP in 107 patients with HF (NYHAⅠ, Ⅱ, Ⅲ, Ⅳ), 30 healthy controls and 28 patients with HF were measured by bidirectional lateral flow immunostaining 3,7 and 15 days after conventional anti-heart failure treatment. And statistical analysis. Results (1) The levels of serum NT-proBNP were significantly higher in patients with heart failure than those in healthy people at different NYHA levels, and the level of serum NT-proBNP increased with the severity of heart failure. (2) Heart failure patients with different cardiovascular diseases Of serum NT-proBNP levels are different, serum NT-proBNP levels were significantly higher in patients with AMI than in other cardiovascular disease groups, serum NT-proBNP levels were the lowest in patients with coronary heart disease and hypertensive heart disease without acute myocardial infarction ; (3) The level of serum NT-proBNP decreased gradually on the 3rd, 7th and 15th day after the treatment, and corresponded with the improvement of the clinical situation. The NT-proBNP concentrations at 3 time points after treatment The magnitude of change was positively correlated with the magnitude of NY-HA classification. Conclusions Serum NT-proBNP level is a strong and objective index reflecting the state of cardiac function. It has important value in the diagnosis, severity and efficacy evaluation of HF.