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目的分析血浆氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)浓度与急性心力衰竭(心衰)患者心功能分级的相关性。方法前瞻性选择新疆医科大学第二附属医院78例住院急性心衰患者,依据出院后随访1年心功能分级分为两组:轻度组36例,纽约心脏协会(New York Heart Association,NYHA)心功能分级1级与2级;重度组42例,心功能NYHA分级3级与4级。比较住院期间两组患者NT-proBNP浓度及心指数(cardiac index,CI)、左心室舒张末期内径(left ventricular end diastolic dimension,LVEDd)、左心室射血分数(left ventricular ejection fraction,LVEF)的差异。应用Pearson相关分析评估NT-proBNP浓度与心功能NYHA分级的相关性,利用多元Logistic回归分析与急性心衰患者心衰加重的危险因素。结果与轻度组相比,重度组血浆NT-proBNP浓度显著较高,差异有统计学意义(P<0.05);两组CI、LVEF及LVEDd比较,差异无统计学意义(P>0.05)。Pearson相关分析显示,NT-proBNP浓度与随访心功能NYHA分级呈正相关(P<0.05),而CI、LVEF及LVEDd与随访心功能NYHA分级无相关性(P>0.05)。多元Logistic回归分析显示,血浆NT-proBNP浓度为急性心衰患者心衰加重的危险因素。结论急性心衰患者血浆NT-proBNP浓度能较好评估其心功能分级情况。
Objective To analyze the correlation between the plasma concentration of NT-proBNP (NT-proBNP) and the grade of heart function in patients with acute heart failure (HF). Methods A total of 78 hospitalized patients with acute heart failure admitted to the Second Affiliated Hospital of Xinjiang Medical University were prospectively selected and divided into two groups according to their 1-year follow-up cardiac function: 36 in the mild group, NYHA (New York Heart Association) Heart function grading 1 and 2; severe group of 42 cases, cardiac function NYHA grading 3 and 4. The differences of NT-proBNP concentration, cardiac index (CI), left ventricular end diastolic dimension (LVEDd) and left ventricular ejection fraction (LVEF) between the two groups during hospitalization were compared . Pearson correlation analysis was used to assess the correlation between NT-proBNP concentration and cardiac NYHA classification. Multivariate Logistic regression analysis was used to analyze the risk factors of heart failure in patients with acute heart failure. Results Compared with mild group, the plasma concentration of NT-proBNP was significantly higher in severe group (P <0.05). There was no significant difference in CI, LVEF and LVEDd between the two groups (P> 0.05). Pearson correlation analysis showed that there was a positive correlation between NT-proBNP concentration and follow-up cardiac NYHA classification (P <0.05), while CI, LVEF and LVEDd had no correlation with follow-up NYHA classification (P> 0.05). Multiple logistic regression analysis showed that plasma NT-proBNP concentration was a risk factor for worsening HF in patients with acute heart failure. Conclusion The plasma NT-proBNP concentration in patients with acute heart failure can better assess the classification of cardiac function.