心力衰竭合并房颤患者血浆脑钠肽水平及相关因素分析

Analysis of the Relative Factors on BNP of Patients with the Combination of Atrial Fibrillation and Heart Failure

目的:探讨心力衰竭合并房颤患者血浆脑钠肽水平变化及相关因素,为心血管疾病的临床诊断提供理论依据。方法:选取我院2011年1月-2013年1月收治的心力衰竭患者94例,分为窦性心律组和心房颤动组。分别抽取两组患者的血液样本并检测血浆中的BNP浓度,比较不同NYHA分级患者血浆内的脑钠肽水平的变化情况,记录左心房和左心室舒张末内径及房颤持续时间等。结果:心力衰竭合并心房颤动组与窦性心律组血浆BNP水平比较,心房颤动组高于窦性心律组;差异有统计学意义(P<0.05);两组NYHA不同分级相互比较,Ⅱ级、Ⅲ级和Ⅳ级间的BNP水平,心房颤动组BNP水平均高于窦性心律组;差异显著具有统计学意义(P<0.05);血浆BNP水平与患者年龄、左心房大小、左心室大小、房颤持续时间因素呈正相关(r分别为0.0.801,0.748,0.854和0.703,P<0.05),与左心室射血分数呈负相关(r=-0.41,P<0.05)。结论:BNP血浆浓度与心功能状态密切相关,BNP浓度的检测有助于临床心血管疾病的诊断。

Objective： To explore the BNP levels of patients in atrial fibrillation combined with heart failure, and to analyze the the correlative factors in order to provide some prospects to the clinical on cardiac diagnosis. Methods： 94 patients with heart failure who were treated in our hospital from January 2011 to 2013 were selected and divided into the sinus rhythm group and the atrial fibrillation group on the basis of presence of atrial fibrillation. The blood samples of patients were taken and the plasma BNP level were detected. Then the end-diastolic diameter of left atrium and ventricular, duration of atrial fibrillation were inspected and the BNP levels of different NYHA classification were compared and analyzed. Results： There was statistically significant difference on the levels of plasma BNP between the heart failure in sinus rhythm group and the atrial fibrillation group （P〈0.05）; At different NYHA grading, there were was statistically significant difference about the BNP levels of II, III and IV（P〈0.05）; There was a positively relative factors to the BNP levels such as the age of patients, the size of the left atrium and ventricular, the duration of atrial fibrillation, as well as the negatively relative factors with the ejection fi＇action of the left ventricular. Conclusion： The BNP level of atrial fibrillation in patients with heart failure was higher and it is helpful to clinical diagnosis of cardiac disease by detecting the concentration of BNP.