我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

N-末端脑钠尿肽原诊断急性心肌梗死患者左室舒张功能的价值及其判断预后的意义

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2009年第5期
页码:
675-677
栏目:
临床研究
出版日期:
2009-07-14

文章信息/Info

Title:
Evaluation of NT-proBNP on left ventricular diastolic function after acute myocardial infarction
作者:
王欢; 李竹琴; 修春红; 李为民; 沈景霞; 薛凤华; 王岚峰
哈尔滨医科大学第一临床医学院心内科，黑龙江 哈尔滨 150001
Author(s):
WANG Huan;  LI Zhu-qin;  XIU Chun-hong;  LI Wei-min;  SHEN Jing-xia;  XUE Feng-hua;  WANG Lan-feng
Department of Cardiology, First Affiliated Hospital, Harbin Medical University, Harbin 150001, Heilongjiang, China
关键词:
N-末端脑钠尿肽原; 心肌梗死; 急性; 左心室舒张功能; 超声心动描记术
Keywords:
N-terminal pro-brain natriuretic peptide;  acute myocardial infarction;  left ventricular diastolic function;  echocardiography
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的: 利用超声心动图，探讨N-末端脑钠尿肽原（NT-proBNP）对急性心肌梗死(AMI)患者左室舒张功能的评价及其意义。方法: 入选左室收缩功能正常的AMI患者66例，测定血浆NT-proBNP水平。根据组织多普勒超声（TDI）及二尖瓣血流频谱指标评价的左室舒张功能，将患者分为4组：A组：左室舒张功能正常组（n=16）；B组：轻度左室舒张功能减低（LVDD）组（n=21）；C组：中度LVDD组（n=24）；D组：重度LVDD组（n=5）。对患者随访12个月，临床终点是因心衰加重或再梗所致再住院和心源性死亡。结果: NT-proBNP水平随着LVDD的加重而显著增高（P<0.01）。NT-proBNP能够独立于其它影响因素判断LVDD，当其水平为962.1 μg/L时，判断LVDD的敏感性是76%，特异性是75%。12个月后发生终点事件患者的血浆NT-proBNP水平与未发生者相比差异有统计学意义（P<0.05）。结论: AMI后NT-proBNP水平能够独立评价LVDD并判断预后。它可用于对AMI患者危险分层并指导临床治疗。
Abstract:
AIM: To investigate the value of NT-proBNP in evaluating left ventricle (LV) diastolic function (DF) of acute myocardial infarction (AMI) patients by echocardiography. METHODS: Sixty-six AMI patients with normal LV systolic function were enrolled and NT-proBNP was determined. LVDF was evaluated by tissue Doppler imaging (TDI) and mitral inflow pulse Doppler. According to the LVDF evaluated by echo indexes, patients were divided into four groups: group A normal LVDF (n=16), group B mild LV diastolic dysfunction (DD) (n=21), group C moderate LVDD (n=24), and group D: severe LVDD (n=5). Patients were followed-up for 12 months and clinical endpoints were rehospitalization caused by exacerbating heart failure or reinfarction, and cardiac death. RESULTS: With increased degree of LVDD, the level of NT-proBNP was significantly elevated (P<0.01). The NT-proBNP level=962.1 μg/L had sensitivity and specificity values of 76% and 73%, respectively, on determining LVDD, independent of other factors. NT-proBNP levels among patients with end events after 12 months and those patients without were significantly different (P<0.05). CONCLUSION: Postinfarction NT-proBNP level can be used independently to evaluate LVDD and predict prognosis and can be used in the risk stratification of AMI patients and for guidance of clinical management.

参考文献/References

［1］ Silver MA. The natriuretic peptide system: kidney and cardiovascular effects［J］. Curr Opin Nephrol Hypertens, 2006, 15(1):14-21.

［2］ 黄高忠,顾军,汤晔华,等. 急性心肌梗死患者血脑钠尿肽前体N末端的变化［J］. 心脏杂志, 2005, 17(5):468-470.

［3］ Maisel A. The Coming of Age of Natriuretic Peptides: The Emperor Does Have Clothes!［J］. J Am Coll Cardiol, 2006, 47(1):61-64.

［4］ Mair J, Hammerer-Lercher A, Puschendorf B. The impact of cardiac natriuretic peptide determination on the diagnosis and management of heart failure［J］. Clin Chem Lab Med, 2001, 39(7):571-588.

［5］ Tschpe C, Kasner M, Westermann D, et al. The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements［J］. Eur Heart J, 2005, 26(21):2277-2284.

备注/Memo

备注/Memo:
收稿日期：2008-2-18.通讯作者：王岚峰, 教授，主要从事冠心病的研究Email:lanfengwang@hotmail. com 作者简介：王欢，助教，硕士Email:jiujiu0427@126.com
更新日期/Last Update: 2009-07-22