中心静脉压与BNP在糖尿病酸中毒合并心衰治疗中的意义

The Significance of Central Venous Pressure and BNP in Diabetic Ketoacidosis with Heart Failure

目的:分析中心静脉压(CVP)与B型脑钠肽(BNP)在糖尿病酸中毒中的变化及相关性,为临床合理补液提供依据。方法:回顾分析132例糖尿病酮症酸中毒患者的病历资料,依据是否合并心衰分为:心衰组73例和非心衰组59例;采用酶联免疫吸附法(ELISA)测定患者血浆BNP,有创心电监护测量CVP。结果:心衰组CVP及BNP较非心衰组明显增高,差异有统计学意义(P<0.01),不同心功能分级CVP与BNP呈正相关(r=0.087、0.092、0.97)。结论:(1)CVP与BNP在糖尿病酮症酸中毒合并急性心衰中均增高;(2)CVP与BNP在糖尿病酮症酸中毒急性心衰中呈正相关性;(3)CVP与BNP的监测可作为临床补液的参考依据。

Objective：To analyze the change and correlation of central venous pressure （CVP） and B-type natriuretic peptide （BNP） in diabeticketoacidosis with heart failure ,to provide a basis for clinical rehydration.Method：A retrospective analysis of 132 cases of diabetic ketoacidosis,who were divided into tow group： heart failure group （73 cases）,non-heart failure group （59 cases） that based on the records,by enzyme-linkedimmunosorbent assay （ELISA） to determine plasma BNP,and measure CVP by invasive ECG. Result：CVP and BNP of heart failure group were obviouslyhigher than non-heart failure group,the difference of tow group were Statistically significant（P0.01）.Statistical significant difference,CVP and cardiacfunction in different BNP was positively correlated （r=0.087,0.092,0.97）.Conclusion： ⑴ CVP and BNP in acute heart failure in diabetic ketoacidosiswere increased. ⑵ CVP and BNP were positively correlated. ⑶ Monitoring of CVP and BNP can be used as a reference for clinical infusion.