【摘要】 目的:探讨慢性心力衰竭患者心脏再同步化治疗(cardiac resynchronizationtherapy,CRT)后早期血浆N末端脑钠肽前体(N-terminal pro-B-type natriureticpeptide,NT-proBNP)变化对患者长期预后评估的价值。方法:采取随机对照的方法,选取40例符合行CRT治疗的慢性心力衰竭患者,分别检测CRT植入前、CRT植入后14 d的血浆NT-proBNP水平,并计算14 d内血浆NT-proBNP水平变化率(△NT-proBNP),根据14 d△NT-proBNP结果分为A组(△NT-proBNP<30%)、B组(△NT-proBNP≥30%),观察CRT植入术后1年内患者的不良心脏事件发生率、病死率、再住院时间及1年后纽约心功能(New York Heart Association,NYHA)分级、左室射血分数(Left ventricular ejection fraction,LVEF)、左室舒张末内径(left ventricular end-diastolic diameter,LVEDD)。结果:B组患者1年不良心脏事件发生率、病死率及左室舒张末内径(LVEDD)均低于A组患者,再住院时间及左室舒张末内径(LVEDD)明显短于A组患者,而NYHA心功能分级、左室射血分数(LVEF)高于A组患者(P<0.05)。结论:慢性心力衰竭患者行CRT后早期NT-proBNP水平变化可以评估患者病情的长期预后。更多还原

【Abstract】 Objective: To evaluate the long-term prognostic value of short-term evariation of plasma N-terminal pro-B-type natriureticpeptide(NT-proBNP) after cardiac resynchronizationtherapy(CRT) treatment in patients with chronic heart failure. Methods:Plasma NT-proBNP levels were measured before CRT, 14 days after CRT in 40 patients with chronic congestive heart failure. The decreasing rate of plasma NT-pro BNP levels(△NT-proBNP)within 14 days was also calculated.The patients were divided into two groups:Agroup(△NT-proBNP<30 %) and B group(△NT-proBNP≥30 %). The incidence of adverse cardiac events, mortality and length of rehospitation were observed within one year after receiving CRT. New York Heart Association(NYHA) functional class, Left ventricular ejection fraction(LVEF), Left ventricular end-diastolic dimension(LVEDD) were also measured one year after receiving CRT.Results: During the period of observation, the incidence of adverse cardiac events, mortality, length of rehospitalization and LVEDD in group B within 1 year were lower than those of patients in group A(P <0.05). Compared with group A, the NYHA functional class,LVEF was higher in group B(P<0.05). Conclusions: The short-term evariation of plasma NT-proBNP before and after CRT treatment can predict the long-term effect of CRT in patients with chronic heart failure.更多还原