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目的:研究慢性心功能不全患者N末端脑钠肽前体(NT-proBNP)和心功能状态在肾小球滤过率(GFR)不同范围内的相关性。方法:连续选择200例慢性心功能不全患者,在病情稳定情况下检测NT-proBNP、血清肌酐水平,评价纽约心功能分级(NYHA),计算GFR。结果:NT-proBNP和NYHA随GFR降低而增加,左室射血分数(LVEF)随GFR降低而降低(均P<0.05);左室舒张末期内径(LVEDd)在不同范围GFR内差异无统计学意义。在GFR水平>45ml/min时,NT-proBNP与NYHA呈正相关,与LVEF呈负相关,与LVEDd无明显相关;在GFR水平<45ml/min时,NT-proBNP与NYHA、LVEF和LVEDd均无明显相关性。结论:慢性心功能不全患者NT-proBNP和心功能状态的关系需考虑不同的肾小球滤过率范围。
AIM: To investigate the association of N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac function in different ranges of glomerular filtration rate (GFR) in patients with chronic cardiac insufficiency. Methods: A total of 200 consecutive patients with chronic cardiac insufficiency were enrolled in this study. NT-proBNP and serum creatinine were measured in stable condition. NYHA and New York Heart Association (NYHA) were evaluated. GFR was calculated. Results: The levels of NT-proBNP and NYHA increased with the decrease of GFR and the LVEF decreased with the decrease of GFR (all P <0.05). There was no significant difference in left ventricular end-diastolic diameter (LVEDd) among different ranges of GFR significance. NT-proBNP was positively correlated with NYHA, negatively correlated with LVEF and had no significant correlation with LVEDd at GFR> 45ml / min. There was no significant difference between NT-proBNP and NYHA, LVEF and LVEDd at GFR <45ml / min Correlation. CONCLUSIONS: The relationship between NT-proBNP and cardiac function in patients with chronic heart failure should be considered in different glomerular filtration rates.