CAJ | 학술논문

目的观察心脏再同步化治疗( CRT)前后心力衰竭患者血清氨基末端B型脑钠肽前体( NT-proBNP)及肌钙蛋白T( TnT)浓度,了解其变化水平对CRT术后疗效评价的可行性。方法根据行CRT效果,117例患者分为有反应组和无反应组。手术治疗前,治疗后6、12个月,分别采用ELISA法检测两组患者血清NT-proBNP及TnT的水平和动态；同时两组患者均进行心脏超声测量患者术前及术后6、12个月的左室射血分数( LVEF)、左室舒张末内径( LVEDD)、左室收缩末期容积( LVESV)。结果 CRT有反应组和无反应组患者在有反应组中行三腔起搏器植入术后6、12个月,有反应组血清NT-proBNP及TnT的ELISA检测浓度显著低于无反应组(P<0.05)；而LVEF均显著高于无反应组(P<0.05)；LVEDD和LVESV均显著下降( P<0.05),而两组术前的左室整体功能差异无统计学意义。 CRT有反应组中,血清NT-proBNP和TnT的水平与患者的心功能改善密切相关。结论通过检测患者术前及术后血清中NT-proBNP和TnT水平变化可以对CRT临床疗效做出评价。
목적관찰심장재동보화치료( CRT)전후심력쇠갈환자혈청안기말단B형뇌납태전체( NT-proBNP)급기개단백T( TnT)농도,료해기변화수평대CRT술후료효평개적가행성。방법근거행CRT효과,117례환자분위유반응조화무반응조。수술치료전,치료후6、12개월,분별채용ELISA법검측량조환자혈청NT-proBNP급TnT적수평화동태；동시량조환자균진행심장초성측량환자술전급술후6、12개월적좌실사혈분수( LVEF)、좌실서장말내경( LVEDD)、좌실수축말기용적( LVESV)。결과 CRT유반응조화무반응조환자재유반응조중행삼강기박기식입술후6、12개월,유반응조혈청NT-proBNP급TnT적ELISA검측농도현저저우무반응조(P<0.05)；이LVEF균현저고우무반응조(P<0.05)；LVEDD화LVESV균현저하강( P<0.05),이량조술전적좌실정체공능차이무통계학의의。 CRT유반응조중,혈청NT-proBNP화TnT적수평여환자적심공능개선밀절상관。결론통과검측환자술전급술후혈청중NT-proBNP화TnT수평변화가이대CRT림상료효주출평개。
Objective To study the dynamic changes of serum N-terminal brain natriuretic peptide ( NT-proBNP) and troponin T ( TnT ) , and its value for the assessment of curative effect of cardiac resynchronization therapy ( CRT) on the patients with heart failure. Methods One hundred and seventeen patients were divided into re-sponder group and no-responder group based on the therapeutic effect of CRT. Concentrations of NT-proBNP and TnT were measured in sera of patients before CRT, and 6 and 12 months after CRT by using enzyme-linked immu-nosorbnent assay ( ELISA) . At the same time, two groups of patients with NYHA grading assessment, the parame-ters of left ventricular ejection fraction ( LVEF) , left ventricular end-diastolic dimension ( LVEDD) , and left ven-tricular end systolic volume ( LVESV) were measured with echocardiography. Results The levels of NT-proBNP and TnT were significantly reduced in responder group compared with no-responder group at 6 th and 12 th month af-ter CRT, and the patients before CRT (P<0.05). The LVEF obviously increased in non-responder group, while LVEDV and LVESV decreased in responder group after 6 and 12 months treatment of CRT when compared with the no-responder group ( P<0.05 ) . The function of left ventricle did not show any difference between the two groups before CRT. More significantly, the dynamic alterations of sera NT-proBNP and TnT were found to be closely asso-ciated with improvement of cardiac function in the responder group after 6 and 12 months of CRT ( P <0.05 ) . Conclusion Kinetic concentrations of serum NT-proBNP and TnT are valuable for assessment of clinical curative effect of CRT.