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目的探讨血浆N末端B型钠尿肽前体(NT-proBNP)水平与超声心动图相关指标在左心室射血分数正常心力衰竭(心衰)患者中的临床意义以及相关性。方法120例左室射血分数正常心衰患者依据纽约心脏协会(NYHA)心功能分级水平分为NYHAⅠ级组、NYHAⅡ级组、NYHAⅢ级组、NYHAⅣ级组。入院后检测血浆NT-proBNP,通过超声心动图血流多普勒检查患者二尖瓣舒张早期血流速度峰值(E)与舒张晚期血流速度峰值(A),以及组织多普勒检查二尖瓣环根部舒张早期运动速度峰值(Ea),计算E/A、E/Ea比值。比较各组患者血浆NT-proBNP水平及E/A、E/Ea比值的差异。通过Pearson分析分析患者血浆NT-proBNP水平与E/A、E/Ea比值相关性。结果四组患者血浆NT-proBNP水平及E/A、E/Ea比值差异均具有统计学意义(P<0.05);除NYHAⅣ组患者与NYHAⅢ组患者E/A比值外,其他指标各组两两比较,差异均具有统计学意义(P<0.05)。Pearson相关分析显示血浆NT-proBNP水平与E/A比值呈轻度负相关(r=-0.22,P<0.05),与E/Ea比值呈正相关(r=0.74,P<0.05)。结论血浆NTproBNP水平与E/Ea比值呈高度相关,对于左室射血分数正常心衰患者病情严重程度判断具有积极价值。血浆NT-proBNP水平越高,E/Ea比值越大,心衰程度越严重。
Objective To investigate the clinical significance and correlation of plasma N-terminal proBNP level and echocardiographic parameters in patients with left ventricular ejection fraction (LVEF) and normal heart failure (HF). Methods One hundred and twenty patients with normal left ventricular ejection fraction (LVEF) were divided into NYHA Ⅰ group, NYHA Ⅱ group, NYHA Ⅲ group and NYHA Ⅳ group according to the New York Heart Association (NYHA) functional class. After admission, plasma NT-proBNP level was measured. Echocardiographic blood flow Doppler was used to examine the relationship between peak mitral diastolic velocity (E) and peak diastolic velocity (A), and tissue Doppler echocardiography The peak value of diastolic early diastolic velocity (Ea) at the root of annulus and the ratio of E / A and E / Ea were calculated. The plasma levels of NT-proBNP and E / A, E / Ea ratio in each group were compared. The Pearson analysis was used to analyze the correlation between plasma NT-proBNP level and E / A, E / Ea ratio. Results The plasma levels of NT-proBNP and the ratio of E / A and E / Ea in the four groups were significantly different (P <0.05). Except for the ratio of E / A in patients with NYHAⅣ and NYHAⅢ, The differences were statistically significant (P <0.05). Pearson correlation analysis showed a slight negative correlation between plasma NT-proBNP level and E / A ratio (r = -0.22, P <0.05), and a positive correlation with E / Ea ratio (r = 0.74, P <0.05). Conclusion The plasma level of NTproBNP is highly correlated with the E / Ea ratio, which has a positive value for judging the severity of the disease in patients with normal left ventricular ejection fraction. The higher the plasma NT-proBNP level, the greater the E / Ea ratio and the more severe the heart failure.