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目的探讨慢性心力衰竭(CHF)患者血浆N端前体脑钠肽(NT-pro BNP)及尿酸(UA)水平测定的临床意义。方法选取108例CHF患者为研究对象(CHF组),根据纽约心脏病协会(NYHA)心功能分级将入选患者分为Ⅱ级32例、Ⅲ级46例、Ⅳ级30例,对照组为60例同期健康体检者。比较两组血浆NT-pro BNP及UA水平、左心房舒张末期内径(LADd)、左心室舒张末期内径(LVDd)、左心室射血分数(LVEF)以及不同心功能分级CHF患者NT-pro BNP及UA水平。将心功能Ⅲ级的患者分为常规组与联合组,常规组给予常规抗心衰治疗,联合组在常规抗心衰治疗的基础上实施别嘌呤醇治疗。结果 CHF组血浆NT-pro BNP及UA水平、LADd、LVDd均明显高于对照组(P<0.05),LVEF明显低于对照组(P<0.05);不同心功能分级患者血浆NT-pro BNP及UA水平比较差异有统计学意义(P<0.05),血浆NT-pro BNP及UA水平随心衰严重程度增高而明显增高;联合组治疗后血浆UA水平明显下降(P<0.05),LVEF明显升高(P<0.05),改善程度均高于常规组(P<0.05)。结论 CHF患者血浆NT-pro BNP及UA水平随心衰严重程度增加而升高,血浆NT-pro BNP及UA水平测定对CHF的诊断和治疗具有重要意义。
Objective To investigate the clinical significance of plasma NT-pro BNP and UA in patients with chronic heart failure (CHF). Methods A total of 108 patients with CHF were enrolled in the study. According to the New York Heart Association (NYHA) classification, 32 patients were classified as grade Ⅱ, 46 as grade Ⅲ and 30 as grade Ⅳ, and 60 as control group Health examination over the same period. NT-pro BNP and UA levels, left atrial end-diastolic diameter (LADd), left ventricular end diastolic diameter (LVDd), left ventricular ejection fraction (LVEF) and NT-pro BNP in patients with different cardiac function classification CHF UA level. Patients with grade Ⅲ heart function were divided into routine group and combined group. Conventional anti-heart failure treatment was given to the conventional group. Allo-purinol treatment was performed on the basis of conventional anti-heart failure treatment. Results The levels of plasma NT-pro BNP and UA, LADd and LVDd in CHF group were significantly higher than those in control group (P <0.05), and LVEF in CHF group were significantly lower than those in control group (P <0.05) (P <0.05). The plasma levels of NT-pro BNP and UA were significantly increased with the severity of heart failure. The level of plasma UA was significantly decreased (P <0.05) and the LVEF was significantly increased (P <0.05), and the improvement was higher than that of the conventional group (P <0.05). Conclusion The plasma levels of NT-pro BNP and UA in CHF patients increase with the severity of heart failure. The determination of plasma NT-pro BNP and UA levels is of great significance for the diagnosis and treatment of CHF.