目的：观察老年冠心病心力衰竭患者脑钠肽前体（NT-proBNP）水平的变化，分析 NT-proBNP 水平对老年心力衰竭早期诊断价值。方法回顾性分析60例老年冠心病心力衰竭患者的临床资料，选取同期治疗的未合并心力衰竭的60例老年患者的临床资料为对照。观察老年冠心病心力衰竭患者和对照组心功能、血脂和 NT-proBNP 指标的差别，分析老年心力衰竭患者 NT-proBNP 水平与心功能、血脂水平的相关性。结果老年心力衰竭组患者的左房内径（LAD）、右房内径（RAD）左心室收缩末期容积（LVESD）、左心室舒张末期内径（LVEDD）水平高于对照组（t ＝16．596、15．920、6．659、10．101，P ＜0．01），左心室射血分数（LVEF）水平低于对照组（t ＝－15．023，P ＜0．01）；心力衰竭组的肌酸激酶、肌酸激酶同工酶、NT-proBNP 和肌钙蛋白（cTnl）水平均高于对照组（t ＝27．481、20．496、25．009、19．423，P ＜0．01）；心力衰竭组患者的总胆固醇、三酰甘油和 LDL 水平高于对照组（t ＝5．810、1．745、5．501，P ＜0．01），HDL 水平低于对照组（t ＝－4．298，P ＜0．01）；老年心力衰竭患者的 NT-proBNP 水平与 LAD、RAD、LVESD、LVEDD、肌酸激酶、肌酸激酶同工酶、CTnl、总胆固醇、三酰甘油和低密度脂蛋白水平正相关，与 LVEF、高密度脂蛋白水平相关。结论老年心力衰竭患者的 NT-proBNP 水平较高，且与患者的血脂和心功能密切相关，可作为临床监测的重要指标。%Objective To observe the changes of NT-proBNP levels in elderly patients with coronary heart dis-ease heart failure,and analyze the value of NT-proBNP level in the early diagnosis of heart failure in elderly patients. Methods The clinical data of elderly patients with coronary heart disease heart failure treated in our hospital from May 201 5 to June 201 6 were retrospectively analyzed.The clinical data of the patients with non heart failure treated in our hospital during the same period were selected as control.To observe the difference of heart function,blood lipids and NT-proBNP indexes in elderly patients with heart failure and control group,and to analyze the correlation between NT-proBNP level and cardiac function and blood lipid level in elderly patients with heart failure.Results The level of LAD,RAD,LVEDD and LVESD in the elderly patients with heart failure were higher than those in the control group (t =1 6.596,1 5.920,6.659,1 0.1 01 ,P <0.01 ),and the level of LVEF was lower than that of the control group(t =-1 5.023,P <0.01 ).The level of creatine kinase,creatine kinase MB,NT-proBNP and CTnl in heart failure group were higher than those in control group (t =27.481 ,20.496,25.009,1 9.423,P <0.01 ).The total cholesterol,triglyceride and LDL levels in the heart failure group were higher than those in the control group (t =5.81 0,1 .745,5.501 ,P <0.01 ),and the level of HDL was lower than that of the control group (t =-4.298,P <0.01 ).NT-proBNP levels in elderly patients with heart failure were positively correlated with LAD,RAD,LVESD,LVEDD,creatine kinase,creatine kinase isoenzyme,CTnl,total cholesterol,triglyceride and LDL levels,and correlated with LVEF and HDL levels. Conclusion The level of NT-proBNP in elderly patients with heart failure is high,and the blood lipids and cardiac function are closely related,which can be used as an important indicator of clinical monitoring.
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