老年慢性心力衰竭患者同型半胱氨酸与N末端B型利钠肽原、左心室结构和功能的相关性

doi:10.3969/j.issn.1004-583X.2016.06.014

临床荟萃

老年慢性心力衰竭患者同型半胱氨酸与N末端B型利钠肽原、左心室结构和功能的相关性

首都医科大学宣武医院心脏科,北京 100053

收稿日期:2016-03-17 出版日期:2016-06-05 发布日期:2016-06-06
通讯作者: 通信作者:华琦,Email:huaqi5371@medmail.com.cn
基金资助:
国家高技术研究发展计划(863计划)资助项目(2012BAI37B03)

Correlation of homocysteine，Nterminal Btype natriuretic peptide， structure and #br# function of left ventricular in elderly patients with chronic heart failure

Department of Cardiology， Xuanwu Hospital， Capital Medical University， Beijing 100053， China

Received:2016-03-17 Online:2016-06-05 Published:2016-06-06
Contact: Corresponding author:Hua Qi,Email:huaqi5371@medmail.com .cn

摘要/Abstract

摘要： 目的探讨老年慢性心力衰竭(chronicheartfailure,CHF)患者同型半胱氨酸(Hcy)水平与N末端B型
利钠肽原(N-terminal-pro-B-typenatriureticpeptide,NT-proBNP)、左心室结构和功能的相关性。方法我院心脏科
住院治疗老年CHF患者84例作为CHF组,依据纽约心脏病学会(NYHA)心功能分级标准将CHF组分为心功能Ⅱ
级34例,Ⅲ级38例,Ⅳ级12例;纳入同期在我院健康体检者78例作为对照组。检测两组患者Hcy、NT-proBNP,运
用彩色多普勒超声进行左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)测定,进行比较及相关性分析。
CHF组患者入院后给予常规治疗基础上加用重组人脑利钠肽(recombinanthumanbrainnatriureticpeptide,rhBNP)
抗心力衰竭治疗,先给予1.5μg/kg负荷量,继之以0.01μg·k-1·min-1静脉持续泵入72小时。在保证血压的情况
下,维持治疗7天,比较治疗前后CHF 组患者Hcy、NT-proBNP,LVEDD 及LVEF。结果 ①CHF 组Hcy、NTproBNP
均较对照组明显升高(P <0.05);②心功能Ⅳ级组Hcy、NT-proBNP水平最高,与心功能Ⅱ、Ⅲ组比较有统
计学意义(P <0.05);心功能Ⅲ级组Hcy、NT-proBNP水平比心功能Ⅱ级组增高(P <0.05);③CHF症状改善后血
清Hcy、NT-proBNP水平较治疗前明显下降(P <0.05);而LVEDD、LVEF治疗前后无明显变化(P >0.05);④
CHF组血清Hcy水平与NT-proBNP、LVEDD呈正相关(r =0.586,r =0.284,P <0.05),与LVEF呈负相关(r =
-0.492,P <0.05)。结论老年CHF患者Hcy水平随着CHF程度的加重而相应升高,与NT-proBNP、LVEDD及
LVEF有良好的相关性,可以反映CHF严重程度。

关键词: 心力衰竭,充血性, 半胱氨酸, N-末端B 型利钠肽原, 老年人

Abstract:

ObjectiveTo investigate the relation between homocysteine (Hcy)， Nterminal Btype natriuretic peptide，structure and function of the left ventricular in elderly patients with chronic heart failure (CHF) . MethodsCHF group included 84 elderly patients with CHF， who were hospitalized in Cardiology at Xuanwu Hospital. According to the criterion of New York Heart Association (NYHA) class，CHF group was divided into three groups， cardiac function grade Ⅱ included 34 cases， grade Ⅲ 38 cases， grade Ⅳ 12 cases. At the same time， control group enrolled 78 cases of healthy people， who had health check in the hospital. Hcy and NTproBNP were detected，the left ventricular enddiastolic diameter (LVEDD)， left ventricular ejection fraction (LVEF ) were measured in two groups using color Doppler ultrasound. CHF group was treated with routine therapies，and recombinant human brain natriuretic peptide(rhBNP)，first given 1.5 μg/kg loading dose， and then intravenous pump 0.01 μg·k-1·min-1 for 72 h.After treatment for 7 days， the clinical data and laboratory results were collected. The data of two groups were compared and correlations were analyzed. Results①Hcy and NTproBNP in CHF group were significantly higher than those of control group(P<0.05); ② Hcy and NTproBNP were the highest in group of cardiac function Ⅳas compared with the groups of heart function Ⅱand Ⅲ(P<0.05); and Hcy and NTproBNP in group of cardiac function Ⅲ were higher than those of cardiac function Ⅱ group(P<0.05); ③Hcy and NTproBNP sharply decreased after the heart failure symptoms improved(P<0.05). However， there were no significant differences in LVEDD， and LVEF before and after the treatment (P>0.05). ④There were positive correlation between the level of Hcy and NTproBNP（r=0.586，P<0.05）， LVEDD（r=0.284，P＜0.05），and the level of Hcy was negatively correlated with LVEF（r=-0.492，P＜0.05）.ConclusionThe level of Hcy is increasing with the aggravating of heart failure and it has great relativity with NTproBNP， LVEDD and LVEF， so it can reflect the severity of heart failure.

Key words: heart failure, congestive, cysteine, Nterminal Btype natriuretic peptide, aged

王紫晨,魏占云,何婧瑜,谭静,华琦. 老年慢性心力衰竭患者同型半胱氨酸与N末端B型利钠肽原、左心室结构和功能的相关性[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2016.06.014.

Wang Zichen， Wei Zhanyun， He Jingyu， Tan Jing， Hua Qi. Correlation of homocysteine，Nterminal Btype natriuretic peptide， structure and #br# function of left ventricular in elderly patients with chronic heart failure[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2016.06.014.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2016.06.014

https://huicui.hebmu.edu.cn/CN/Y2016/V31/I6/644

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老年慢性心力衰竭患者同型半胱氨酸与N末端B型利钠肽原、左心室结构和功能的相关性

Correlation of homocysteine，Nterminal Btype natriuretic peptide， structure and #br# function of left ventricular in elderly patients with chronic heart failure

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