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目的:探讨氨基末端脑钠素前体(NT-proBNP)水平对慢性心力衰竭患者病情评估的临床价值。方法:选择慢性心力衰竭患者135例,以NYHA方法评估其心功能,部分患者行超声心动图检查测定左室射血分数(LVEF);采用ELISA法测定NT-proBNP水平,放射免疫法测定肾素-血管紧张素-醛固酮系统激素水平。结果:随着心功能级别增高,NT-proBNP水平递增,Ⅰ级(1例)、Ⅱ级(47例)、Ⅲ级(65例)和Ⅳ级(22例)的NT-proB-NP水平分别为61、746、1668和4720ng/L。各级间均差异有统计学意义(P<0·01)。血管紧张素原、肾素、血管紧张素Ⅱ及醛固酮的血浆水平,随心功能或LVEF变化不显著或无规律性。结论:NT-proBNP水平对于慢性心力衰竭患者的病情评估具有较高的价值,且优于肾素-血管紧张素-醛固酮系统激素。
Objective: To investigate the clinical value of the level of NT-proBNP in patients with chronic heart failure. Methods: One hundred and thirty-five patients with chronic heart failure were selected and their cardiac function was assessed by NYHA method. Left ventricular ejection fraction (LVEF) was measured by echocardiography in some patients. NT-proBNP level was measured by ELISA and radioimmunoassay Angiotensin - aldosterone system hormone levels. Results: The level of NT-proBNP increased with the increase of cardiac function level. The level of NT-proBNP in grade Ⅰ (1 case), grade Ⅱ (47 cases), grade Ⅲ (65 cases) and grade Ⅳ 61,746,1668 and 4720 ng / L. The differences among all levels were statistically significant (P <0.01). Plasma levels of angiotensinogen, renin, angiotensin II and aldosterone did not change significantly or irregularly with cardiac function or LVEF. CONCLUSIONS: NT-proBNP levels are of high value in the assessment of disease in patients with chronic heart failure and are superior to the renin-angiotensin-aldosterone system hormones.