急性心力衰竭患者血清UA及BNP水平变化的临床观察

Clinical observation of serum UA and BNP level changes in patients with acute heart failure

目的通过观察急性心力衰竭(HF)患者血清尿酸(UA)及B型尿钠肽(BNP)水平的变化,进一步探讨其临床意义。方法 80例健康体检者为对照组,80例经临床确诊的HF患者为观察组,采用彩色多普勒超声诊断仪检测左室射血分数(LVEF);采用全自动生化分析仪测定血清UA水平;采用免疫分析仪检测BNP水平;观察组治疗3 w^4 w后复查超声心动图及UA、BNP水平,进一步观察治疗前后各指标变化及UA、BNP水平与LVEF的相关性。结果观察组血清UA、BNP水平明显高于对照组,LVEF明显低于对照组(P<0.05或P<0.O1);HF控制后血清UA、BNP水平明显降低(P<0.O1);血清UA、BNP浓度、LVEF三者之间密切相关,血清UA与BNP水平呈正相关(r=0.723,P<0.05);血清UA与LVEF相关性分析呈负相关(r=-0.611,P<0.05);血BNP水平与LVEF呈负相关(r=-0.719,P<0.05)。结论血清UA、BNP水平变化对HF诊断、严重程度及预后评价有重要临床应用价值。

Objective To observe the changes of plasma UA and BNP levels in patients with acute heart failure （HF）, so as to further discuss the clinical significance. Methods Eighty healthy volunteers as control group, 80 clinically - diagnosed HF pa- tients as observation group were collected to detect left ventricular ejection fraction （LVEF） with colored Doppler ultrasonogra- phy, serum UA levels with automatic biochemical analyzer, and BNP levels with Immunoassay analyzer. Echocardiography and UA, BNP levels of the observation group were reexamined after treatment for 3 -4 weeks to analyze the correlation of UA, BNP levels and LVEF. Results Plasma UA, BNP levels of the observation group were significantly higher, while LVEF was signifi- cantly lower than those in the control group. The difference was statistically significant （P 〈 0.05 or P 〈 0.01 ）. The levels of plasma BNP and UA lowered distinctly when HF was controlled（P 〈0.01 ）. Plasma UA, BNP and LVEF were closely related. Plasma UA was positively correlated to BNP （r = 0. 723, P 〈 0. 05） and negatively correlated to LEVF （r = -0. 611, P 〈 0.05 ） ; The simple relative analysis indicated that the plasma BNP level was negatively correlated to LVEF（ r = - 0.719, P 〈 0.05）. Conclusion Changes of plasma UA, BNP levels were useful for diagnosis, severity evaluation and prognosis of HF.