摘要
目的探讨老年原发性高血压(EH)射血分数保留的心力衰竭(HF-PEF)患者血浆氨基末端脑钠肽前体(NT-proBNP)、二尖瓣口舒张早期最大血流峰值(E峰)/二尖瓣心房收缩期最大血流峰值(A峰)、左心室质量指数(LVMI)的变化及其意义。方法选取2017年3月~2019年5月确诊的老年EH伴HF-PEF患者90例作为HF-PEF组、另外90例单纯EH患者作为EH组.采用ELISA法检测2组的血浆NT-proBNP水平,采用超声心动图检测2组的左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、E/A及LVMI值,采用受试者工作曲线(ROC)分析NT-proBNP、E/A及LVMI值鉴别诊断EH患者并发HF-PEF的价值。结果HF-PEF组的血浆NT-proBNP水平高于EH组,E/A值低于EH组,LVMI值高于EH组,差异均有统计学意义(P<0.05);但2组LVEF、LVEDD值的差异无统计学意义(P>0.05)。ROC曲线分析结果显示,血浆NT-proBNP鉴别诊断EH并发HF-PEF的灵敏度为88.20%、特异度为97.21%,ROC曲线下AUC值为0.940;E/A值鉴别诊断EH并发HF-PEF的灵敏度为85.41%,特异度为94.39%,ROC曲线下AUC值为0.922;LV鉴别诊断EHMI并发HF-PEF的灵敏度为74.90%,特异度为88.17%,ROC曲线下AUC值为0.827。结论老年EH伴HF-PEF患者NT-proBNP、LVMI值增大,E/A降低,检测上述三项指标对于诊断HF-PEF有一定的价值。
Objective To investigate the changes of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP),maximal peak blood flow in early diastole of mitral valve(peak E)(peak E)/maximal peak blood flow during mitral atrial systole(peak A)and left ventricular mass index(LVMI)in elderly patients with essential hypertension(EH)and heart failure with preserved ejection fraction(HF-PEF)and their significance.Methods 90 elderly EH patients with HF-PEF diagnosed from March 2017 to May 2019 were selected as HF-PEF group,and 90 simple EH patients were selected as EH group.The plasma NT-proBNP level was detected by ELISA,and the left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),E/A and LVMI were measured by echocardiography.Receiver operating curve(ROC)was used to analyze the value of NT-proBNP,E/A and LVMI in the differential diagnosis of HF-PEF in EH patients.Results The plasma NT-proBNP level of HF-PEF group was significantly higher than that of EH group,E/A value was lower than that of EH group,LVMI was larger than that of EH group.The above differences between the two groups were statistically significant(P<0.05).But there was no significant difference in LVEF and LVEDD between the two groups(P>0.05).ROC curve analysis results showed that the sensitivity of plasma NT-proBNP in differential diagnosis of EH with HF-PEF was 88.20%,the specificity was 97.21%,the AUC value under ROC curve was 0.940;the sensitivity of E/A value in differential diagnosis of EH with HF-PEF was 85.41%,the specificity was 94.39%,and the AUC value under the ROC curve was 0.922;the sensitivity of LV differential diagnosis of EHMI with HF-PEF was 74.90%,the specificity was 88.17%,and the AUC value under the ROC curve was 0.827.Conclusion The NT-proBNP and LVMI increased and E/A decreased in elderly EH patients with HF-PEF.The detection of the above three indexes has a certain value in the diagnosis of HF-PEF.
作者
吴兴雷
金叶
Wu Xinglei;Jin Ye(Department of Emergency Medicine,Central Hospital of Fengxian District of Shanghai City.Shanghai,201499,P.R.China)
出处
《老年医学与保健》
CAS
2021年第1期177-180,共4页
Geriatrics & Health Care
关键词
老年
原发性高血压
射血分数保留的心力衰竭
氨基末端脑钠肽前体
elderly
essential hypertension
heart failure with preserved ejection fraction
amino terminal brain natriuretic peptide precursor
