CAJ | 학술논문

目的探讨 N 末端脑利钠肽原(Nt-proBNP)和血钠水平与老年慢性心力衰竭(CHF)患者预后的关系.方法以老年 CHF 患者为研究对象,随访1年,根据随访期间是否发生心血管事件分为心血管事件组(65例)和非心血管事件组(50例).采用双抗夹心免疫荧光法测定两组患者血浆 Nt-proBNP 水平,常规测定电解质、生化、血常规、血管紧张素原、肾素、血管紧张素Ⅱ和醛固酮水平,比较两组间的差异.并采用 Lgistic 回归分析探讨心血管事件的危险因素.结果心血管事件组 Nt-proBNP 明显高于非心血管事件组,血钠明显低于非心血管事件组,差异均有统计学意义(均 P<0.01).Nt-proBNP 与血钠水平呈显著负相关(r=-0.865,P<0.01).Nt-proBNP 及血钠与心血管事件明显相关(P<0.05或0.01),左室舒张末期内径、左室射血分数、年龄均与心血管事件无明显相关(P>0.05).结论 Nt-proBNP 是老年 CHF 患者心血管事件的独立危险因素,但受心室大小和 LVEF 影响不大,可能与低钠血症有关.
목적탐토 N 말단뇌리납태원(Nt-proBNP)화혈납수평여노년만성심력쇠갈(CHF)환자예후적관계.방법이노년 CHF 환자위연구대상,수방1년,근거수방기간시부발생심혈관사건분위심혈관사건조(65례)화비심혈관사건조(50례).채용쌍항협심면역형광법측정량조환자혈장 Nt-proBNP 수평,상규측정전해질、생화、혈상규、혈관긴장소원、신소、혈관긴장소Ⅱ화철고동수평,비교량조간적차이.병채용 Lgistic 회귀분석탐토심혈관사건적위험인소.결과심혈관사건조 Nt-proBNP 명현고우비심혈관사건조,혈납명현저우비심혈관사건조,차이균유통계학의의(균 P<0.01).Nt-proBNP 여혈납수평정현저부상관(r=-0.865,P<0.01).Nt-proBNP 급혈납여심혈관사건명현상관(P<0.05혹0.01),좌실서장말기내경、좌실사혈분수、년령균여심혈관사건무명현상관(P>0.05).결론 Nt-proBNP 시노년 CHF 환자심혈관사건적독립위험인소,단수심실대소화 LVEF 영향불대,가능여저납혈증유관.
Objective To investigate the correlation of serum N-terminal-pro-brain natriuretic peptide (Nt-proBNP) and sodium levels with major adverse cardiac and cerebral events (MACCE) in patients with chronic heart failure (CHF). Methods One hundred and fifteen elderly patients with CHF were included in the study. Patients were followed up for 1 year and the inci-dence of MACCE was recorded. The blood Nt-proBNP, electrolytes, angiotensinogen, renin, angiotensin II and aldosterone levels were measured along with blood routine and blood biochemistry on the admission. Logistic regression analysis and survival analysis were applied for the risk factors of MACCE. Results During the 1-y fol ow-up period MACCE developed in 65 cases. The Nt-proBNP level in the MACCE group (n=65) was significantly higher than that in non-MACCE group (n=50)(P<0.01). The Nt-proBNP was negatively correlated with serum sodium level(r=-0.865, P<0.01). Nt-proBNP was positively and serum sodium was negatively correlated with MACCE, while LVEDD, LVEF and age were not correlated with MACCE. Conclusion Nt-proBNP is an independent risk factor of MACCE in elderly patients with CHF. Nt-proBNP level may be related to the decreased level of serum sodium, not the LVEDD or LVEF.