UA、TBIL以及BNP水平与慢性心衰病情进展及临床疗效之间关联的相关性分析

Regression Analysis of the Relationship Between the Reduction of UA and TBIL Levels and the Progression and Clinical Efficacy of Chronic Heart Failure

目的探讨血清胆红素、尿酸和B型利钠肽水平与慢性心衰病情进展及临床疗效之间的相关性。方法选取2013年1月至2015年12月在我院确诊并接受治疗的慢性心力衰竭患者89例为研究组,并按照NYHA标准分级法对研究组患者进行分组,同期选取35例心功能正常者做为对照组,所有受试人员于入院当天对其血清胆红素(TBIL)、尿酸(UA)以及B型利钠肽(BNP)水平进行检测,心衰患者在经过1周治疗后再次检测,并对其进行统计分析。结果与对照组健康人群相比,研究组患者的TBIL、UA、BNP水平和左室舒张末期内径(LVDd)明显提高,而左室射血分数(LVEF)水平显著降低,且两组之间差异具有统计学意义(P<0.01);研究组患者随着心功能等级的升高,患者血清中TBIL、UA和BNP水平逐级升高,且相互之间差异显著(P<0.05);相关性分析结果表明患者的TBIL、UA和BNP水平与LVEF呈负相关,与心功能分级以及LVDd呈正相关;在经过治疗后患者各指标均具有明显的改善,且与治疗前比较,差异具有统计学意义(P<0.05)。结论慢性心力衰竭患者血清TBIL、UA和BNP的监测对于及时诊断、评估病情以及疗效评价有一定的临床意义,值得临床推广应用。

Objective To analyze the association between serum bilirubin, uric acid and brain natriuretic peptide expression levels and the progression of chronic heart failure and the their clinical efficacy. Methods 89 patients with chronic heart failure who were diagnosed and treated in our hospital from January 2013 to December 2015 were selected as study group. According to NYHA standard grading group of patients in the study group, during the same period, we selected 35 cases with normal heart function as a control group. All subjects had their serum bilirubin, uric acid and brain natriuretic peptide content detected on the day of admission. For patients with heart failure, we measured again after a week of treatment, and performed statistical analysis. Results Compared with the control group, the levels of TBIL, UA, BNP and LVDd were significantly higher in the study group, while the LVEF level was significantly lower, and there was a significant difference between the two groups （P 〈 0.01) ;In the study group, the levels of BNP, TBIL and UA were increased in the serum of the patients with the increase of cardiac function grade, and the difference was significant(P 〈 0.05);The correlation analysis showed that TBIL,UA and BNP levels were negatively correlated with LVEF and positively correlated with cardiac function grade and LVDd. After the treatment, the patients had significant improvement in all indicators, and with significant differences compared with pre-treatment (P 〈 0.05). Conclusion The monitoring of TBIL, UA and BNP levels in patients with CHF has clinical significance for timely diagnosis, evaluation of disease and evaluation of efficacy, and worthy of clinical application.