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目的探讨慢性心力衰竭(CHF)患者的血清脑钠肽(BNP)水平的变化规律和病情评估中的临床意义。方法将160例慢性心力衰竭患者作为研究对象,其中NYHA心功能Ⅱ级50例,Ⅲ级58例,Ⅳ级52例。另选取健康体检者160例作为对照组,比较CHF患者与健康者的血清BNP水平、左室射血分数(LVEF)和左心室舒张末期内经(LVEDd)。结果 CHF患者的BNP水平明显高于对照组(P<0.05),BNP水平随患者NYHA心功能分级升高而增高(P<0.05),BNP升高时,患者LVEF下降,而LVEDd则降低(P<0.05)。随访18个月内,CHF患者中心功能未改善者其BNP水平未见明显下降,其在随访期间病死率、住院次数和总住院时长明显高于心功能改善组的患者,差异均有统计学意义(P<0.05)。结论血清BNP水平能够有效反映出慢性心力衰竭患者的左心室功能情况,其对于慢性心力衰竭的诊断和病情评估有着重要的指导性,可作为心力衰竭的重要标准物。
Objective To investigate the changes of serum brain natriuretic peptide (BNP) in patients with chronic heart failure (CHF) and the clinical significance of the disease evaluation. Methods A total of 160 patients with chronic heart failure were enrolled in this study. Among them, NYHA cardiac function was grade Ⅱ in 50 cases, grade Ⅲ in 58 cases and stage Ⅳ in 52 cases. Another 160 healthy subjects were selected as the control group. The serum BNP level, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDd) were compared between CHF patients and healthy controls. Results BNP level in CHF patients was significantly higher than that in control group (P <0.05). BNP level increased with NYHA functional class (P <0.05). LVEF decreased and LVEDd decreased <0.05). Within 18 months of follow-up, there was no significant decrease of BNP level in patients with CHF without improvement of function. The mortality, hospital stay and total length of stay during follow-up were significantly higher than those in patients with improvement of heart function (P <0.05). Conclusions Serum BNP levels can effectively reflect the left ventricular function in patients with chronic heart failure. It has important guiding significance in the diagnosis and assessment of chronic heart failure, and can be used as an important standard for heart failure.