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目的:测定老年舒张性心力衰竭(DHF)患者治疗前、后血N末端脑利钠肽原(NT-ProBNP)和C反应蛋白(CRP)的水平,探讨老年DHF时NT-ProBNP和CRP的变化及其意义。方法:选取59例经临床治疗后心力衰竭改善的老年DHF患者,根据Lester等〔1〕介绍的美国DHF的超声诊断方法,按DHF的分级分组:弛缓受损组(25例),假性正常化充盈组(19例),限制性充盈组(15例),并选取22例心功能正常者作为对照组。监测DHF患者治疗前、后的血NT-ProBNP和CRP水平。结果:①老年DHF患者的NT-ProBNP和CRP值明显高于对照组(P<0.05)。②老年DHF患者假性正常化充盈组的NT-proBNP和CRP值显著高于弛缓受损组(P<0.05),限制性充盈组的NT-proBNP和CRP值显著高于弛缓受损组及假性正常化充盈组(P<0.05)。③老年DHF患者治疗后NT-ProBNP和CRP均显著下降(P<0.05)。结论:血浆NT-ProBNP和CRP在老年DHF患者中明显升高,且升高幅度随着舒张功能不全程度的加重而升高,对疗效观察和病情转归有一定的实用的临床价值。
Objective: To determine the levels of N-terminal pro-brain natriuretic peptide (NT-ProBNP) and C-reactive protein (CRP) in elderly patients with diastolic heart failure (DHF) before and after treatment and to investigate the changes of NT-ProBNP and CRP And its significance. Methods: Fifty-nine elderly patients with DHF improved by clinical treatment of heart failure were enrolled in this study. According to the American DHF ultrasound diagnosis introduced by Lester et al [1], DHF was divided into two groups according to DHF: flaccid group (n = 25) Filling filling group (19 cases), restrictive filling group (15 cases), and 22 cases of normal heart function as a control group. Blood levels of NT-ProBNP and CRP were monitored before and after treatment in DHF patients. Results: (1) NT-ProBNP and CRP in elderly patients with DHF were significantly higher than those in the control group (P <0.05). (2) The NT-proBNP and CRP values in the normalized filling group were significantly higher than those in the flaccid impaired group (P <0.05), and the NT-proBNP and CRP values in the restricted filling group were significantly higher than those in the impaired and impaired group Normalized filling group (P <0.05). (3) NT-ProBNP and CRP were significantly decreased in elderly patients with DHF (P <0.05). CONCLUSIONS: Plasma NT-ProBNP and CRP levels are significantly elevated in elderly patients with DHF, and the increase rate increases with the degree of diastolic dysfunction. It has some practical clinical value for the observation of curative effect and prognosis.