心功能不全患者NT—proBNP浓度水平及影响因素分析

罗京资　邱军明　胡汉斌　何洪钟　湛昌文

【摘要】 目的：探究心功能不全患者NT-proBNP濃度水平及影响因素。方法：2016年5月-2017年2月本院收治的心功能不全患者95例作为观察组，以同期心脏功能正常的健康体检者95例作为对照组。比较两组NT-proBNP、NYHA心脏功能分级情况、肾脏功能及心脏功能指标（心率、心房颤动、心房内径、左心房舒张压末内径、LVEF血清肌酐）等一般临床资料，采用Logistic多元回归分析心功能不全患者中NT-proBNP影响因素。结果：两组年龄、性别比较，差异均无统计学意义（P>0.05），两组体重指数、收缩压、舒张压、心率、血清肌酐、NYHA分级（Ⅰ、Ⅱ、Ⅲ、和Ⅳ级）、心房颤动、心房内径、左心房舒张压末内径和左心室射血分数比较，差异均有统计学意义（P<0.05）；观察组NT-proBNP水平显著高于对照组（P<0.05）；观察组中对各指标进行分层，NT-proBNP的血清浓度中位数及其自然对数比较，差异均有统计学意（P<0.05）。Logistic回归分析结果：心功能不全患者NT-proBNP水平升高和心律、收缩压、心房颤动、左心室舒张压末内径、血清肌酐和LVEF水平变化相关（P<0.01）。结论：心功能不全患者的血浆NT-proBNP浓度显著升高，血清中的NT-proBNP浓度同时还受到肾脏排泄功能、心脏射血、收缩压等多因素的影响，利用NT-proBNP对心脏功能进行评价时应综合多因素进行分析。

【关键词】 心功能不全； NT-proBNP； 多元回归分析； 影响因素

Analysis of NT-proBNP Concentration Level and Its Influencing Factors in Patients with Cardiac Dysfunction/LUO Jing-zi，QIU Jun-ming，HU Han-bin，et al.//Medical Innovation of China，2017，14（26）：037-040

【Abstract】 Objective：To investigate NT-proBNP concentration level and its influencing factors in patients with cardiac dysfunction.Method：From May 2016 to February 2017，95 patients with cardiac dysfunction in our hospital were treated as the observation group，and 95 healthy cases of normal cardiac function as the control group.NT-proBNP and NYHA classification of cardiac function，renal function and cardiac function parameters（heart rate，atrial fibrillation，atrial diameter，left atrial diameter，end diastolic blood pressure，serum creatinine，LVEF）were compared between two groups，and Logistic multiple regression analysis was used to analyze the influencing factors of NT-proBNP in patients with cardiac dysfunction.Result：The age and sex of two groups were no significant difference（P>0.05），the body mass index，systolic blood pressure，diastolic blood pressure，heart rate，serum creatinine，NYHA grading（Ⅰ，Ⅱ，Ⅲ，Ⅳ），atrial fibrillation，atrial inner diameter，left ventricular diastolic diameter and left ventricular ejection fraction of two groups to compared，the differences were statistically significant（P<0.05），NT-proBNP level of the observation group was significantly higher than that of the control group（P<0.05），stratification of each index in the observation group，the serum NT-proBNP concentration and the median natural logarithm ratio to compared，the differences were statistically significant（P<0.05）.Logistic regression analysis showed that cardiac function insufficiency patients NT-proBNP level elevation and cardiac rhythm，systolic blood pressure，atrial fibrillation，left ventricular end diastolic pressure，serum creatinine and LVEF level change were correlated（P<0.01）.Conclusion：The plasma NT-proBNP concentration increased significantly of cardiac insufficiency patients，and plasma NT-proBNP concentration is also affected by many factors of renal excretory function，cardiac ejection，systolic blood pressure and et al，and evaluate the cardiac function by NT-proBNP should be comprehensive multi factor analysis.endprint

【Key words】 Cardiac insufficiency； NT-proBNP； Multiple regression analysis； Influencing factors

First-authors address：Guangzhou Traditional Chinese and Western Medicine Hospital，Guangzhou 510800，China

doi：10.3969/j.issn.1674-4985.2017.26.010

氨基端脑钠素原（N-teminal proBNP，NT-proBNP）是脑钠素在向B型脑钠肽素原转化过程中的产物[1-2]。研究显示，相比于B型钠肽素原NT-proBNP有半衰期长、浓度高、无生物活性能够进行年龄分层划分等优点，可以作为早期心功能损伤的重要血清标记物以评估心脏功能[3-4]。有报道显示，人体中的NT-proBNP受到多种因素的影响包括：年龄、性别、体重指数、肾脏功能和心脏受损程度[5-7]。本研究旨在通过95例心功能不全患者和95例健康体检者的对比来探究NT-proBNP在心脏不全患者中的水平变化及其影响因素，现报道如下。

1 资料与方法

1.1 一般资料 以2016年5月-2017年2月本院收治的心功能不全患者95例作为观察组，并在本院进行了NT-proBNP项目的检查，以同期本院心脏功能正常的健康体检者95例作为对照组。观察组男65例，女30例；年龄……