天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (6): 624-627.doi: 10.11958/j.issn.0253-9896.2015.06.012

• 临床研究 • 上一篇    下一篇

不同中医证型心力衰竭患者左心室射血分数与NT-proBNP、HCY、D-D的关系

温学红， 闫卫利， 马明坤， 杨龙艳   

  1. 天津中医药大学第二附属医院
  • 收稿日期:2014-09-18 修回日期:2015-01-12 出版日期:2015-06-15 发布日期:2015-06-10
  • 通讯作者: 温学红 E-mail:xh-wen@163.com
  • 基金资助:
    国家自然科学基金资助项目 （81273939）

Correlation of left ventricular ejection fraction as well as serum levels of NT-proBNP, Hcy and#br# D-D with different traditional Chinese medicine syndrome types of chronic heart failure

WEN Xuehong， YAN Weili, MA Mingkun， YANG Longyan   

  1. The Second Affiliated Hospital of Tianjin Medical University

  • Received:2014-09-18 Revised:2015-01-12 Published:2015-06-15 Online:2015-06-10

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摘要： 目的 研究不同中医证型的心力衰竭患者左心室射血分数 （LVEF） 与 N 末端脑钠肽前体 （NT-proBNP）、 同型半胱氨酸 （Hcy）、 D-二聚体 （D-D） 的关系。方法 将 178 例慢性心衰患者依照 LVEF 分 2 组： LVEF 正常的心衰组（HFNEF） 86 例和 LVEF 减低的心衰组（HFREF） 92 例， 以心功能正常者 35 例为对照组。根据中医证型将心衰患者分为 3 组： 气阴两虚组 64 例， 气虚血瘀组 59 例， 阳虚水停组 55 例。应用多普勒超声检查测量 LVEF， 测定血清 NTproBNP、 Hcy 和 D-D 水平。结果 3 组的 NT-proBNP、 Hcy、 D-D 水平， 均是 HFREF 组＞HFNEF 组＞对照组， 对于LVEF， HFREF 组＜HFNEF 组＜对照组(均 P < 0.05)。对于 HFNEF 患者， 阳虚水停组的 LVEF 低于气阴两虚组(P＜0.05)。不同证型组间的 NT-proBNP、 Hcy、 D-D 水平差异无统计学意义。对于 HFREF 患者， 不同证型组间 LVEF 比较差异无统计学意义； NT-proBNP 水平： 气阴两虚组 < 气虚血瘀组 < 阳虚水停组； Hcy、 D-D 水平： 阳虚水停组高于气阴两虚组和气虚血瘀组（P＜0.05）。结论 随 LVEF 的改变， 不同中医证型的血 NT-proBNP、 Hcy、 D-D 水平呈现一定趋势的变化， 以射血分数减低组中不同证型间各指标的变化比射血分数正常组更为明显。

关键词: 心力衰竭, 每搏输出量, 利钠肽, 脑, 中医证型, 左室射血分数, N 末端脑钠肽前体, 同型半胱氨酸, D-二聚体

Abstract: Objective To investigate the correlation of left ventricular ejection fraction (LVEF) as well as serum levels of NT-proBNP, Hcy and D-Dimer (D-D) with different traditional Chinese medicine (TCM) syndrome types of chronic heart failure (CHF). Methods A total of 178 CHF patients were divided into heart function normal ejection fracture group (HFNEF, n=86) and heart function reduction (HFREF, n=92) according to their LVEF performance. Another 35 cases with normal cardiac function were included in control group. All CHF patients was also divided into 3 TCM syndrome types: "both deficiency of Qi and Yin syndrome group" (n=64), "Qi asthenia causing blood stasis syndrome group" (n=59) and "Yang deficiency water stop group" (n=55). All patients were examined with cardiac color doppler and LVEF values were recorded.And serum NT-proBNP、 Hcyand D-D levels were all quantified. Results As to serum levels of NT-proBNP, Hcy and DD, they were higher in HFREF group than those in HFNEF group than those in control group. On the other hand, LVEF was
lowest in HFREF group but highest in control group. All differences were statistically significant (P < 0.05). Among patient in HFNEF group, LVEF in the "Yang deficiency water stop group" was lower than that in "both deficiency of Qi and Yin syndrome group" (P < 0.05). Serum levels of NT-proBNP, Hcy, and D-D were not significantly different between different TCM syndrome groups. By contrast, among patients in HFREF group, LVEF values did not differ significantly between different TCM syndrome groups. Serum level of NT-proBNP was lower in "both deficiency of Qi and Yin syndrome group" than that in Hcy and D-D, they are higher in "Yang deficiency water stop group" that those in "both deficiency of Qi and Yin syndrome（P＜0.05). Conclusion Patients with different TCM syndrome types of CHF present different levels of serum NT-proBNP, Hcy, D-D level and LVEF. Changes of indicators in HFREF groups are more obvious than they did in HFNEF group.

Key words: heart failure, stroke volume, natriuretic peptide,brain, traditional Chinese medicine syndrome types,
LVEF, NT-proBNP, Hcy, D-dimer