肺心病心功能不全患者B型利钠肽水平改变的临床意义

The clinical significance of brain natriuretic peptide levels variety in patients with pulmonary heart disease patients with heart failure

目的分析肺心病心功能不全患者B型利钠肽(BNP)水平改变的临床意义。方法选取肺心病心功能不全患者80例,另选取同期健康体检者80例,对比分析2组BNP、PaO_2、Pa CO_2及肺动脉压力变化。分析NYHA心功能分级与BNP关系及BNP与LVEF、LVEED的关系。结果观察组BNP、Pa CO_2及肺动脉压力水平高于对照组,PaO_2水平低于对照组,差异均有统计学意义(P<0.05)。对照组BNP升高2例少于观察组的79例,差异有统计学意义(P<0.01)。NYHA心功能分级级别越高其BNP水平也逐渐升高,两两比较均存在显著差异(P<0.01),阳性检出率也明显增高。通过BNP水平与心脏结构、功能指标行直线相关分析,发现BNP与LVEF呈负相关(r=-0.867,P<0.05),当LVEF越低,其BNP水平就越高。血浆BNP与LVEED呈正相关(r=0.198,P<0.05)。结论 BNP水平改变在肺心病心功能不全患者中有显著的临床意义,不仅能够作为诊断肺心病心功能不全的指标,还能够评估患者病情变化。

Objective To analysis the clinical significance of brain natriuretic peptide levels variety in patients with pulmonary heart disease patients with heart failure. Methods Selected 80 cases patients with pulmonary heart disease patients with heart failure as observation group. Selected 80 cases health checker as control group. Compared the level of BNP、PaO2、Pa CO2 and pulmonary pressure of 2 groups,Analysis the relationship between NYHA functional class and BNP,analysis the relation of BNP,LVEF,LVEED. Results The level of BNP、Pa CO2 and pulmonary pressure of observation group was higher than that of control group,the level of PaO2 was lower than that of control group,the difference was statistic significant（ P〈0. 05）.In the control group,BNP increased in 2 cases,less than 79 cases in the observation group,the difference was statistic significant（ P〈0. 01）. The higher the level of NYHA cardiac function was,the higher its BNP level was,and there was a significant difference（ P〈0. 01）,and the positive detection rate was also significantly higher. By linear correlation analysis of BNP levels with cardiac structure and function indexes,it showed that BNP was negatively correlated with LVEF（ r =-0. 867,P〈0. 05）.The lower the LVEF,the higher the BNP level. Plasma BNP was positively correlated with LVEED（ r = 0. 198,P〈0. 05）. Conclusion The clinical significance of brain natriuretic peptide levels variety in patients with pulmonary heart disease patients with heart failure was significant. Not only can be used as an indicator of the diagnosis of pulmonary heart disease insufficiency,but also to assess the patient＇s condition changes.