目的 探讨舒张性心力衰竭(心衰)患者左房容积指数和血清脑钠肽前体的相关性.方法 选择60例因舒张性心衰入院的患者,根据纽约心功能分级分为Ⅱ、Ⅲ、Ⅳ级三组,选取20例健康人为对照组.应用超声心动图测量受试者的左房容积(LAV),左房容积指数(LAVI),二尖瓣舒张早期血流峰值和组织多普勒舒张早期峰值比值(E/E'),同时检测血清脑钠肽前体[Nt-Pro-Brain Natriuretic Peptide(Nt-Pro-BNP)]等指标.对四组E/E'、LAV、LAVI和Nt-Pro-BNP水平进行比较,同时Nt-Pro-BNP和LAVI作相关性分析.结果 舒张性心衰三组患者的LAVI(31.9±8.32 ml/m2、40.08±7.04 ml/m2、47.7±13.80 ml/m2)显著大于健康对照组的LAVI(26.73±9.90 ml/m2),且随着心功能的恶化,LAVI和Nt-Pro-BNP均随之升高(P<0.05),两者呈正相关(r=0.760,P<0.001),LAVI诊断舒张性心力衰竭的ROC曲线下的面积为0.805,根据ROC曲线,当LAVI取值为35.4 ml/m2时灵敏度和特异度之和最大,超过此值可考虑存在舒张性心衰.结论 舒张性心衰患者LAVI和Nt-Pro-BNP有一定的相关性,是反映舒张性心衰患者心功能状况的有效指标.%Objective To discuss the correlation between left atrial volume index (LAVI) and serum N-terminal pro brain natriuretic peptide (NT-proBNP) in patients with diastolic heart failure.Methods The patients (n=60) were chosen and divided, according to NYHA grading, into group Ⅱ, group Ⅲ and group IV, and 20 health controls were chosen as control group. The indexes of left atrial volume (LAV), LAVI, the ratio of left ventricular peak early diastolic mitral flow velocity (E) to early diastole inflow velocity (E, E/E') were detected by using Doppler echocardiogram. The level of serum NT-proBNP was detected at the same time. The changes of E/E', LAV and LAVI and NT-proBNP level were compared among 4 groups, and correlation between NT-proBNP level and LAVI was analyzed.Results LAVI (31.9±8.32 mL/m2, 40.08±7.04 mL/m2, 47.7±13.80 mL/m2) was higher in group II, group Ⅲ and group IV than that in control group (26.73±9.90 mL/m2). LAVI and NT-proBNP increased as heart function worsened (P<0.05), and they were positively related to each other (r=0.760,P<0.001). The area under ROC curve of LAVI was 0.805 for diagnosing diastolic heart failure. When LAVI was 35.4 mL/m2, the sum of specificity and sensitivity was the maximum. If LAVI was over 35.4 mL/m2, diastolic heart failure would be diagnosed. Conclusion LAVI is correlated to NT-proBNP in patients with diastolic heart failure, which can be taken as an effective index for reflecting heart function.
展开▼
