BNP联合心率变异性在心力衰竭患者短期预后中的预测研究

Research of BNP Combined with Heart Rate Variability for Prediction the Short-term Prognosis of Patients with Heart Failure

目的:探讨BNP和心率变异性在心力衰竭患者短期预后中的临床意义。方法:选取2013年9月至2014年9月入本院治疗的76例心力衰竭患者为研究对象,测定血浆BNP浓度并分析其与左心室舒张末内径(LVDD)、左心室射血分数(LVEF)的关系及与患者再住院率和死亡率之间的关系;并对患者进行心电图记录和超声心动图检查,对心率变异性进行分析。结果:血浆BNP水平升高随着患者NYHA分级升高而增大,二者呈正相关。且BNP浓度越高短期再住院率明显增高,且病情加重,死亡率升高(P<0.05);死亡组患者与存活组比较显示,死亡组患者室性早搏和室速发作频度较高,且时域指标SDANN、SDNN、p NN50与频域指标LF/HF均较低,差异有统计学意义(P<0.05);且超声动图指标LVEDV与LVESV均有显著性差异(P<0.05)。结论:BNP和心率变异性分析对心力衰竭的临床诊断均有指示性,二者联合对心力衰竭短期预后的预测具有重要的临床意义。

Objective： To study the clinical significance of BNP combined with heart rate variability for prediction the short-term prognosis of patients with heart failure. Method： 76 cases of heart failure patients treated in our hospital from September 2013 to September 2014 were selected as the research object, concen- tration of plasma BNP was determined, the relationship of BNP with the left ventricular end-diastolic diame- ter （ LVDD）, left ventricular ejection fraction （LVEF） were analysed, and the relationship between the hos- pitalization rate and mortality, And the patients electrocardiogram and echocardiography were recorded, the heart rate variability was analyzed. Result： The plasma BNP levels increased as NYHA classification for in- creasing, both were positively correlated. And the BNP concentration was significantly higher, the higher the short-term hospitalization rates again and became seriously ill, and mortality increased （P〈O.05） ; Com- pared with survival group, Death group patients with ventricular premature and ventricular tachycardia at- tacks frequency was higher, and the time domain index SDANN, SDNN, pNNSO and frequency domain in- dex LF/HF were low, the difference was statistically significant （P〈 0.05） ; And ultrasonic dynamic figure index LVEDV and LVESV had significant difference （P 〈 0.05）. Conclusion： Analysis of BNP and heart rate variability are indicative for the clinical diagnosis of heart failure, the joint can be used as a short-term prognosis of heart failure prediction, which has important clinical significance.