【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962.1μg/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。更多还原

【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.更多还原