氮末端B型利钠肽原与老年2型糖尿病患者心脏舒张功能的关系

Clinical study of N-terminal pro-plasma brain natriuretic peptide in aged patients of type 2 diabetes mellitus with diastolic heart failure

关键词:  2型糖尿病  脑钠素  心脏舒张功能不全  老年

Key words:  diabetes mellitus  brain natriuretic peptide  diastolic heart failure  elderly

摘要:

[目的] 探讨血浆氮末端B型脑钠肽(NT-proBNP)水平与老年2型糖尿病伴舒张性心功能不全(DHF)的关系及早期诊断的临床意义。[方法] 选取67例采用超声心动图检测心脏收缩功能正常的老年2型DM患者，按二尖瓣舒张早期血流速度／二尖瓣舒张晚期血流速度(E／A)比值分为心功能正常组22例，DHF 1级组18例，DHF 2级组17例，DHF 3级组10例。正常对照组为本院健康体检者23例。采用电化学发光法测定各组血浆NT-proBNP水平。[结果] 与正常对照组和心功能正常组比较，老年2型糖尿病伴DHF组的NT-proBNP水平差异具有显著性意义(P<0.01)；NT-proBNP值随着舒张功能不全程度加重而逐渐提高，与E/A比值呈显著负相关(r=-0.78, P<0.01）。[结论] 血浆NT-proBNP水平与老年2型糖尿病患者的心脏舒张期功能障碍程度密切相关，可反映老年2型糖尿病患者的心脏舒张功能状态。

Abstract:

[Objective] To study the relationship and diagnostic value between n-terminal pro-brain natriuretic peptid (NT-proBNP ) and the severity of diastolic heart failure (DHF) in aged patients of type 2 diabetes mellitus. [Methods] 67 type 2 diabetic mellitus aged patients and 23 healthy subjects served as control were selected into the study. Left ventricular ejection fraction (LVEF) and mitral annular early diastole (E) and late diastole (A) inflow velocities were measured with Doppler echocardiography．According to the ratio of E to A, the severity of DHF patients were subdivided into 3 groups: DHF 1 group (0.8≤E／A<1, n=18), DHF 2 group (0.6≤E／A<0.8, n=17),DHF 3 group(E／A<0.6,n=10),and without DHF group(E/A≥1,n=22). The plasma level of NT-proBNP was measured by the enzyme-linked immunosorbent assay. [Results] Plasma level of NT-proBNP was significantly increased（P<0.01）in type 2 diabetes mellitus with DHF（1538±237.9）pg/mL as compared with those without DHF（896.5±168.7）pg/mL and health subject （768.8±123.4） pg/mL. Plasma levels of NT-proBNP significantly increased according to the severity of DHF. Plasma NT-proBNP negatively correlated with the ratio of E/A in type 2 diabetes mellitus aged patients with DHF (r=-0.78, P<0.01). [Conclusion] The plasma level of NT-proBNP closely reflects the severity of diastolic heart failure in aged patients with type 2 diabetes mellitus.