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目的定量检测慢性心力衰竭(CHF)病人血浆N端B型钠尿肽(NT-proBNP)水平,分析其与中医分型间的相关性,探讨NT-proBNP作为CHF中医辨证分型客观指标的可行性。方法306例纽约心脏病学会(NYHA)心功能分级Ⅱ级~Ⅳ级的CHF病人入院后行中医辨证分型,用化学发光方法测定血浆NT-proBNP水平。NYHA心功能分级变化≥1个级别时,再次进行中医辨证分型和NT-proBNP测定。共获得408份CHF病人的完整资料。采用Spearman相关分析检验不同中医证型与NT-proBNP的相关性。结果CHF病人总体(n=408)血浆NT-proBNP水平显著高于健康对照组(n=72,Z=-12.788,P<0.05);NT-proBNP水平随心力衰竭加重而上升,与NYHA分级呈正相关(Spearman相关分析,偏相关系数r=0.7494,P<0.05);NT-proBNP水平按心气虚兼血瘀证→心气阴两虚兼血瘀证→心脾阳虚兼血瘀水停证→心脾肾阳虚水饮泛滥证顺序增加(r=0.7061,P<0.05)。结论NT-proB-NP作为CHF中医辨证分型的生物学指标之一具有可行性。
Objective To quantitatively test the level of plasma N-terminal B-type natriuretic peptide (NT-proBNP) in patients with chronic heart failure (CHF) and analyze its correlation with TCM classification and explore the feasibility of using NT-proBNP as an objective index of TCM syndrome differentiation in CHF Sex. Methods 306 New York Heart Association (NYHA) patients with cardiac function grade Ⅱ ~ Ⅳ were admitted to the hospital for TCM syndrome differentiation. Plasma NT-proBNP levels were measured by chemiluminescence. NYHA cardiac function classification changes ≥ 1 level, once again TCM syndrome differentiation and NT-proBNP determination. A total of 408 copies of CHF patients were obtained. Spearman correlation analysis was used to test the correlation between TCM syndrome types and NT-proBNP. Results The plasma level of NT-proBNP in CHF patients was significantly higher than that in healthy controls (n = 72, Z = -12.788, P <0.05). The levels of NT-proBNP increased with the increase of heart failure, (Spearman correlation analysis, partial correlation coefficient r = 0.7494, P <0.05); NT-proBNP levels according to heart Qi and blood stasis syndrome → cardiorespiratory syndrome and blood stasis syndrome → Heart and spleen yang deficiency and blood stasis of water syndrome → Heart, spleen and kidney yang water flooding order increased (r = 0.7061, P <0.05). Conclusion NT-proB-NP as one of the biological indicators of TCM syndrome differentiation of CHF is feasible.