脑卒中继发左室舒张功能不全与血清脑钠肽水平的相关性

Correlation between serum BNP level and left ventricular diastolic dysfunction secondary to stroke

目的探讨脑卒中继发性左心舒张功能不全患者与血清脑钠肽水平的相关性。方法将750例脑卒中患者中180例继发性左心舒张功能不全患者按随机数字表法分为研究组和对照组，均予以血管紧张素Ⅱ受体拮抗剂＋G2受体阻滞剂治疗，研究组在此基础上联合螺内酯治疗，观察2个月。统计患者左室功能不全发生率、时间、病灶部位状况；统计研究组与对照组治疗后心衰发生率及治疗前后射血分数EF及E／A值变化，观察两组血压变化；治疗前后检测研究组与对照组血清脑钠肽、白蛋白、肌酐、尿素氮水平。结果本组脑卒中患者继发左室功能不全发生率为24．0％；治疗后研究组发生心衰（13．6％）显著低于对照组（45．6％）（P〈0．01），射血分数EF值及E／A值显著高于对照组（P〈0．05），血压水平控制明显好于对照组（P〈0．05）；两组血清脑钠肽、肌酐、尿素氮水平较治疗前显著下降，血清白蛋白水平较治疗前显著升高（P〈0．05），但研究组血清脑钠肽水平显著低于对照组（P〈0．01），血清白蛋白水平显著高于对照组（P〈0．01）。结论脑卒中患者继发性左心舒张功能不全发生率较高，与血清脑钠肽水平变化密切相关，检测血清脑钠肽水平的变化有助于判断继发性左室舒张功能不全的发生状况。

Objective To observe the correlation between serum BNP level and left ventricular diastolic dysfunction secondary to stroke. Methods From 750 patients with stroke, 180 cases with secondary left ventricular diastolic dysfunction were selected and divided into observation group and control group. They were all given ARB＋β2 receptor blockers, experiment group were given ARB＋β2 receptor blockers ＋Al- dosterone antagonists, they were observed for 2 months. Occurrence rate, time, lesion location condition of left ventricular diastolic dysfunction of patients were analyzed; incidence of heart failure, changes of EF, E/A, blood pressure of patients were observed; BNP, AIB, Cr, BUN level of patients before and af- ter were detected. Results Secondary left ventricular dysfunction in this group was 24% ; after treatment, heart failure occurrence rate of experiment group （13. 6%） was significantly lower than control group （45.6 %）（P〈0.01）, EF, E/A value were obviously higher than control group （P〈0.05）, control of bp level was obviously better than control group （P〈0. 05） ; BNP, Cr, BUN level of the two groups were significantly declined than before, ALB level was significantly increased after treatment （P〈0.05）, BNP of experiment group was significantiy lower than control group （P〈0.01）, ALB level was significantly higher than control group （P〈0.01）. Conclusions Left ventricular diastolic dysfunction secondary to stroke has higher occurrence rate, it is closely related with changes of BNP level, the detection of BNP level is conducive to judgment of secondary left ventricular diastolic dysfunction.