慢性心力衰竭患者血浆BNP、血UA水平与心力衰竭严重程度及预后的相关性研究

Correlation research between the level of plasma BNP, UA and the severity of heart failure and prognosis in patients with chronic heart failure

目的分析慢性心力衰竭（CHF）患者治疗前后血浆B型脑钠肽（BNP）、血尿酸（UA）的变化，评价血浆BNP、血UA水平与心力衰竭严重程度及预后的相关性。方法选择慢性心力衰竭患者170例作为CHF组，按美国纽约心脏病协会（NYHA）评分分为三个亚组，即心功能Ⅱ级组56例，心功能Ⅲ级组90例，心功能Ⅳ级组24例；另选30例同期体检健康成人作为对照组，均进行血浆BNP、血UA检测，同时CHF患者经常规抗心力衰竭治疗后测定血浆BNP、血尿酸的水平，比较慢性心力衰竭患者治疗前后血浆BNP、血UA的变化，分析其与NYHA心功能分级、射血分数及预后的相关性。结果CHF组血浆BNP、血UA水平高于对照组（P〈0.05），其升高程度与心力衰竭程度紧密相关，血浆BNP、血UA水平越高，心功能分级越高，左室射血分数（LVEF）越低。治疗后血浆BNP、血UA水平与心功能分级及射血分数具有相关性。慢性心力衰竭患者治疗后血浆BNP、血UA水平高者，心脏事件发生率高，临床预后差。结论血浆BNP、血UA可作为评估心力衰竭严重程度的指标，其水平随着心功能分级的增加而增加，心功能改善后血浆BNP、血UA水平降低，LVEF升高。可客观地评估患者的病情状况，观察治疗效果，判断临床预后。

Objective To analyze the changes of plasma B-type natriuretic peptide （BNP） and uric acid （UA） in patients with chronic heart failure （CHF） before and after treatment, and to evaluate their correlations with severity and prognosis of heart failure.Methods All 170 cases of patients with CHF were selected as CHF group, and were divded into three subgroups according to cardiac function score by the New York Heart Association（NYHA）, with 56 cases in grade Ⅱ subgroup, 90 cases in grade Ⅲ subgroup and 24 cases in grade Ⅳ subgroup; and 30 healthy subjects checked in the same period were selected as control group. The levels of plasma BNP and UA in control group were detected, and the levels of pbsma BNP and UA in CHF group were compared before and after commn anti-heart failure treatment. The correlations between NYHA classifications, ejection fraction and prognosis in chronic heart failure patients were analyzed.Results Levels of BNP and UA in CHF group were significantly higher than those in control group （P〈0.05）, the correlation analysis showed that with the gradual increase of the levels of Plasma BNP and UA, the cardiac function classification and the degree of heart failure gradually increased, and left ventricale ejection fraction （LVEF） decreased. The patients with high levels of BNP and UA had a high incidence rate of cardiac events, and the clinical prognosis was poor.Conclusions The plasma BNP and UA can be used as the indexes to evaluate the severity of heart failure, and with the increase of the cardiac function classification, they will also increase. The levels of plasma BNP and UA will reduce after improving the heart function, contrarily, LVEF will increase, so that it can evaluate the illness situation of patients objectively, observe the effect of treatment and judge the clinical prognosis.