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HFpEF患者血浆脑钠肽与超声心动图及心电图的相关性分析

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摘要:

目的 探讨射血分数保留心衰(HFpEF)患者血浆脑钠肽(BNP)与超声心动图及心电图的相关性。方法 选取2018年10月至2020年9月于天长市人民医院收治的90例HFpEF患者作为研究组,另选取同期于我院常规体检的心功能正常者30例作为对照组,比较两组、不同NYHA心功能分级HFpEF患者的血浆BNP、超声心动图及心电图相关参数;采用Person相关性分析血浆BNP与超声心动图、心电图参数的相关性;采用ROC曲线分析超声心动图参数对HFpEF的诊断效能。结果 研究组血浆BNP、LAVI、IVST、E/e′、TRVmax、QT间期、QTc间期、QTd均显著高于对照组(P<0.05),e′显著低于对照组(P<0.05);不同心功能分级HFpEF患者的血浆BNP、LAVI、IVST、E/e′、TRVmax、QT间期、QTc间期、QTd、e′比较存在显著差异(P<0.05);经Person相关性分析显示,BNP与LAVI、IVST、E/e′、TRVmax、QTc间期呈显著正相关(P<0.05),与e′呈显著负相关(P<0.05);通过超声心动图LAVI、IVST、E/e′值诊断HFpEF的ROC曲线可知,LAVI、IVST、E/e′值诊断HFpEF的AUC分别为0.911、0.950、0.867,灵敏度分别为82.2%、88.9%、84.8%,特异度分别为90.0%、90.0%、76.7%,诊断截点值分别为33.371 ml/m2、11.565 mm、12.188。结论 HFpEF患者血浆BNP与超声心动图、心电图相关参数存在一定相关性,三者联合检测能够提高HFpEF的诊断及预测价值。

Abstract:

Objective To discuss the correlation among plasma brain natriuretic peptide (BNP), echocardiography and electrocardiogram (ECG) in patients with heart failure with preserved ejection fraction (HFpEF). Methods HFpEF patients (n=90) were chosen into research group and controls with normal heart function (n=30) were chosen into control group from People’s Hospital of Tianchang City from Oct. 2018 to Sept. 2020. The parameters related to plasma BNP, echocardiography and ECG were compared between 2 groups and among patients with different grades of NYHA cardiac classification. The correlation among plasma BNP, echocardiography and ECG was analyzed by using Person correlation analysis, and diagnostic efficacy of echocardiography parameters to HFpEF by using ROC curve. Results The levels of plasma BNP, LAVI, IVST, E/e′, TRVmax, QT interval, QTc interval and QTd were significantly higher (P<0.05), and e′ was significantly lower (P<0.05) in research group than those in control group. The comparison in BNP, LAVI, IVST, E/e′, TRVmax, QT interval, QTc interval, QTd and e′ showed significant difference in HFpEF patients with different grades of NYHA cardiac classification (P<0.05). The results of Person correlation analysis showed that BNP was positively correlated to IVST, E/e′, TRVmax and QTc interval (P<0.05), and negatively correlated to e′ (P<0.05). The results of ROC curve analysis showed that AUC of LAVI, IVST and E/e′ was, respectively, 0.911, 0.950 and 0.867 in HFpEF diagnosis by echocardiography, sensitivity was, respectively, 82.2%, 88.9% and 84.8%, specificity was, respectively, 90.0%, 90.0% and 76.7%, and diagnostic cutoff value was, respectively, 33.371 ml/m2, 11.565 mm and 12.188. Conclusion There is correlation among parameters of plasma BNP, echocardiography and ECG in HFpEF patients, and combination of plasma BNP, echocardiography and ECG can improve diagnostic and predictive value to HFpEF.

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