血清脑钠肽浓度与慢性心力衰竭严重程度相关性分析

Serum brain natriuretic peptide concentration and severity with chronic heart failure in coronary heart disease

目的研究血清N-末端脑钠肽浓度与左心功能分级、左室射血分数、左室舒张末期内径之间的关系。方法选慢性心力衰竭患者79例,按照美国纽约心脏病协会(NYUA)分级,心心功能Ⅱ级19例,Ⅲ级32例,Ⅳ级28例,同时纳入正常健康体检组20例做为对照,观察两组脑钠肽、左室舒张未内径以及左室射血分数。结果慢性心衰BNP数值随NYNA分级升高而升高,与NYHA成正相关(r=0.687),与LEVEF成负相关(r=-0.713),与LVEDD成相关(r=0.716),心力衰竭各级别心功能的BNP水平和LEVDD明显高于健康对照组(P<0.01),各级别组间比较差异均有显著性意义(P<0.01)。经心衰标准化治疗2周后,血清脑钠肽水平下降≥30%较<30%的患者1年内死亡率低(χ2=14.21,P<0.01)。结论血清脑钠肽对慢性心衰的早期诊断,判断心衰严重程度及预后有非常重要的价值。

Objective To explore the diagnostic value of the serum N-terminal brain and the relationship between chronic heart failure. Methods 79 patients with chronic heart failure, according to the New York Heart Association （NYUA） classification, Heart function Ⅱ 19 cases, Ⅲ grade 32 cases,Ⅳ grade 28 cases, while the included 20 cases of normal healthy volunteers as a control group, were observed brain natriuretic peptide, left ventricular diastolic internal diameter and left ventricular ejection fraction. Results BNP values with chronic heart failure NYNA grade temperature increased, a positive correlation with NYHA （r=0.687）, and negatively correlated with LEVEF into （r=-0.713）, associated with LVEDD into （r=0.716）, heart failure BNP levels and LEV-DD all levels of cardiac function was significantly higher than the healthy control group （P〈0.01）, differences were significant be-tween groups at all levels （P〈0.01）. Standardized treatment of heart failure after two weeks, serum brain natriuretic peptide levels decreased ≥30% compared with 〈30% of patients one year mortality rate is low （χ2= 14.21,P〈0.01）. Conclusion Early diagnosis of serum brain natriuretic peptide on chronic heart failure, determine the severity and prognosis of heart failure has a very impor-tant value.