老年心律失常患者左心室舒张功能不全与血浆 BNP 及临床特点的研究

Study of plasma BNP and clinical symptoms in elderly arrhythmia patients with left ventricular diastolic dysfunction

目的：研究老年心律失常患者左心室舒张功能不全（LVDD）与血浆 BNP 及临床特点。方法收集2012年9月至2013年12月在郑州大学第一附属医院老年心血管科住院的心律失常的老年患者96例，入院后分别行常规心电图、动态心电图、血浆脑钠肽（BNP）水平检测、心脏彩超检查。结果 LVDD 组患者血浆 BNP 为（537±61）pg/ ml，明显高于对照组的（119±47）pg/ ml（P 〈0.01），并且 BNP 水平随着 LVDD 分级（Ⅰ-Ⅲ级）而升高（P 〈0.05）；胸闷、气短、心悸、头晕及胸痛是老年心律失常患者最常见的临床症状，LVDD 组头晕、心悸的发生率明显高于对照组，差异有统计学意义（P 〈0.05）。结论老年心律失常患者临床表现多，症状重，应给予及时减慢心率及维持窦律；血浆 BNP 可以作为评价左心室舒张功能不全的指标，而且可以反映左心室舒张功能不全的严重程度，可以将 BNP 作为左心室舒张功能不全患者诊断及随访指标。

Objective To study the plasma BNP and clinical symptoms in elderly arrhythmia pa-tients with left ventricular diastolic dysfunction（LVDD）. Methods Ninety-six elderly arrhythmia pa-tients in department of cardiology of geriatrics of this hospital from September 2012 to December 2013 were observed. All patients underwent routine electrocardiogram（ ECG）,Holter ECG monitoring,the level of plasma BNP,transthoracic echocardiographic exam after they were admitted to hospital. Results Compared with the normal LVDD group[（119 ± 47）pg / ml],the level of plasma BNP were significantly elevated in patients with left ventricular diastolic dysfunction group[（537 ± 61）pg / ml]（P 〈 0. 01）. BNP level gradually increased from LVDD class I to III（P 〈 0. 05）. The most clinical symptoms in eld-erly arrhythmia patients were sense of suppression in the chest,breathe hard,palpitation,dizzy and chest pain. The incidence of palpitation and dizzy was significantly higher in LVDD group than that in the nor-mal LVDD group（P 〈 0. 05）. Conclusions The clinical symptoms were serious in elderly arrhythmia patients and should slower heart rate and maintain cardiac rhythm in time. The level of plasma BNP can be regarded as one of indexes for left ventricular diastolic dysfunction and can reflect the different degrees of left ventricular diastolic dysfunction,BNP can be employed as the diagnostic and follow-up parameter in patients with left ventricular diastolic dysfunction.