心力衰竭患者N末端B型利钠肽原浓度变化观察.docVIP

心力衰竭患者N末端B型利钠肽原浓度变化观察 　　doi：10.3969/j.issn.1007-614x.2014.20.73 　　摘 要 目的：观察收缩性心衰与舒张性心力衰竭住院患者N末端B型利钠肽原（NT-proBNP）情况。方法：2011年3月-2012年3月收治心力衰竭患者84例，所有患者均为心力衰竭Ⅲ～Ⅳ级且行入院即刻和出院前天NT-proBNP检查，比较所收集的舒张性心衰与同期收缩性心衰患者入院即刻和出院前NT-proBNP情况。结果：舒张性心衰与收缩性心衰比较，入院NT-proBNP中位数分别为3 165.8 ng/ml，4 348.6 ng/ml，出院前NT-proBNP中位数分别为1 437.6 ng/ml，668.3 ng/ml。结论：入院时舒张性心衰患者NT-proBNP浓度比收缩性心衰低；出院时舒张性心衰患者NT-proBNP水平较收缩性心衰高。 　　关键词 心力衰竭 舒张性 收缩性 N末端B型利钠肽原 　　Observation of N terminal B type natriuretic peptide concentration changes in patients with heart failure 　　Yang Xin 　　Department of Cardiology，Taiyuan Railway No.3 Engineering Central Hospital，Shanxi 030006 　　Abstract Objective：To observe the N terminal B type natriuretic peptide（NT-proBNP） situation of patients with systolic heart failure and diastolic heart failure.Methods：84 cases with heart failure were selected from March 2011 to March 2012.Allcases had heart failure in grade Ⅲ to Ⅳ and were given NT-proBNP examination at admission and discharge the day before yesterday.The collected NT-proBNP situation of patients with diastolic heart failure and systolic heart failure at admission and before discharge.Results：Diastolic heart failure compared with systolic heart failure，the median of NT-proBNP at admission were 3165.8 ng/ml and 4348.6 ng/ml.The median of NT-proBNP before discharge were 1437.6 ng/ml and 668.3 ng/ml.Conclusion：At admission，the NT-proBNP concentration of patients with diastolic heart failure was lower than that of systolic heart failure.When out of the hospital，the NT-proBNP concentration of patients with diastolic heart failure was higher than that of systolic heart failure. 　　Key words Heart failure；Diastolic；Systolic；N terminal B type natriuretic peptide 　　流行病学研究显示，近年来随着社会人口老龄化和住院患者的高龄，心力衰竭发病率和住院率渐趋增高，也有越来越多心衰住院患者射血分数正常，经心脏超声证实舒张功能减低，称为舒张性心力衰竭或收缩功能正常的心力衰竭。N末端B型利钠肽原（NT-proBNP）在心室容积扩张和压力负荷增加下分泌明显增高，是功能失代偿最敏感和最特异指标[1]，NT-proBNP目前的研究多面对整体心衰人群，而在舒张性心衰和收缩性心衰中表达是否有不同资料尚少，本研究收集失代偿性心衰NT-proBNP情况，并比较两种心衰浓度变化，探讨心衰患者NT-proBNP情况