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目的探讨社区队列人群血浆NT-proBNP水平的分布状况。方法横断面调查北京首钢社区734例具有心血管疾病高危因素的队列人群,运用电化学发光免疫技术测定血浆NT-proBNP水平。收集人群心血管疾病病史情况如心肌梗死、心绞痛、高血压病、心房颤动,并收集有无糖尿病病史;对受试者进行NYHA分级评估,行超声心动图测量左心室射血分数,并依据二尖瓣口血流多普勒、二尖瓣环组织多普勒、肺动脉血流多普勒对左心室射血分数正常者进行左心室舒张功能分级分组(正常、轻度受损、中/重度受损)。分析不同人群血浆NT-proBNP水平情况。结果该人群中NYHAⅠ级86.5%,Ⅱ级12.9%;左心室射血分数<50%者占3.5%。该人群的血浆NT-proBNP水平中位数为69.75 ng/L。血浆NT-proBNP水平在有冠心病者高于无冠心病者(108.60 ng/L比65.68ng/L,P<0.05),有高血压者高于无高血压者(72.71 ng/L比61.51 ng/L,P<0.05),有房颤者高于无房颤者(93.31ng/L比67.61 ng/L,P<0.05),有糖尿病者高于无糖尿病者(80.05 ng/L比66.04 ng/L,P<0.05),NYHA分级Ⅱ级者高于Ⅰ级者(115.5 ng/L比65.01 ng/L,P<0.05),左心室射血分数降低者高于左心室射血分数正常者(293.8ng/L比67.85 ng/L,P<0.05),舒张功能正常、轻度受损、中/重度受损和未定型人群血浆NT-proBNP水平分别为53.73 ng/L、75.07 ng/L、101.85 ng/L和269.75 ng/L。结论社区人群血浆NT-proBNP水平虽处于相对较低水平,但可能对早期监测各种心血管疾病导致心功能变化有一定临床意义。
Objective To investigate the distribution of plasma NT-proBNP in community cohorts. Methods A cross-sectional survey of 734 cohorts from Beijing Shougang community with risk factors for cardiovascular disease was performed. Plasma NT-proBNP levels were measured by electrochemiluminescence immunoassay. Collect the history of cardiovascular diseases such as myocardial infarction, angina pectoris, hypertension, atrial fibrillation, and collect the history of diabetes mellitus; subject to NYHA classification assessment, echocardiography measured left ventricular ejection fraction, and according to two Doppler of mitral valve orifice, Doppler of mitral annular tissue and Doppler of pulmonary artery blood flow were used to classify left ventricular diastolic function in normal left ventricular ejection fraction (normal, mild, moderate / severe Damaged). Analysis of plasma NT-proBNP levels in different populations. Results The population NYHA Ⅰ 86.5%, Ⅱ grade 12.9%; left ventricular ejection fraction <50% accounted for 3.5%. The population had a median plasma NT-proBNP of 69.75 ng / L. Plasma NT-proBNP levels were higher in those with coronary heart disease than those without coronary heart disease (108.60 ng / L vs 65.68 ng / L, P <0.05), those with hypertension were higher than those without hypertension (72.71 ng / L vs 61.51 ng (93.31ng / L vs 67.61 ng / L, P <0.05), patients with diabetes were higher than those without diabetes (80.05 ng / L vs 66.04 ng / L, P <0.05) / L, P <0.05) .NHHA grade Ⅱ was higher than grade Ⅰ (115.5 ng / L vs 65.01 ng / L, P <0.05), and the decrease of left ventricular ejection fraction was higher than that of left ventricular ejection fraction (293.8ng / L vs 67.85 ng / L, P <0.05). The diastolic function was normal and mildly impaired. The levels of NT-proBNP in the moderately / severely impaired and undetermined population were 53.73 ng / L and 75.07 ng / L, respectively , 101.85 ng / L and 269.75 ng / L respectively. Conclusions Although the plasma NT-proBNP level in community population is relatively low, it may be of clinical significance to early monitor the changes of cardiac function caused by various cardiovascular diseases.