山区慢性心力衰竭患者症状评估与氨基末端脑钠肽检测值的关系

Evaluation of symptoms in chronic heart failure patients in mountain areas and its relationship with detection value of amino-terminal brain natriuretic peptide

目的探讨山区慢性心力衰竭患者症状评估与氨基末端脑钠肽(NT-BNP)检测值关系。方法选取山区慢性心力衰竭患者906例,行一般情况调查、症状评估、NT-BNP检测,分析治疗前后NT-BNP检测值分布情况,分析治疗前NT-BNP与心功能状况、肝肾指标的关系,分析治疗后NT-BNP下降情况与不同年龄段患者冠心病症状改善情况。结果治疗前,随着NT-BNP检测值增加,左心室(LV)异常率、室间隔厚度(IVS)异常率、射血分数(EF)异常率、合并房颤发生率、总胆固醇(TC)异常率、低密度脂蛋白胆固醇(LDL-C)异常率、总蛋白(TP)异常率、尿素氮(BUN)异常率、血肌酐(Cr)异常率显著增加(P<0.05),心功能分级更为严重。治疗后,患者NT-BNP检测值显著改善(P<0.05)。NT-BNP检测值下降越明显,冠心病症状改善人数显著增加(P<0.05)。患者年龄越大,冠心病症状改善效果显著较差(P<0.05)。结论山区慢性心力衰竭患者症状较为严重,常合并高血脂症、高血压、糖尿病等,与NT-BNP检测值关系密切。

Objective To investigate Evaluation of symptoms in chronic heart failure patients in mountain areas and its relationship with detection of amino-terminal brain natriuretic peptide（NT-BNP）. Methods A total of 906 patients with chronic heart failure in mountain areas were selected, were performed general investigation, symptom assessment, and NT-BNP detection, and the distribution of NT-BNP values before and after treatment was analyzed. The relationship between NT-BNP and cardiac function, liver and kidney parameters before treatment was analyzed. The reduction condition of NT-BNP after treatment and improvement of coronary heart disease symptoms in patients with different ages were analyzed. Results Before treatment, with the increasing of detection value of NT-BNP, abnormality rates of left ventricle （LV）, interventricular septal thickness （IVS）, and ejection fraction （EF）, the incidence rate of atrial fibrillation, and abnormality rate of total cholesterol （TC）, low-density lipoprotein cholesterol（LDL-C）, total protein （TP）, urea nitrogen （BUN）, and serum creatinine （Cr） were significantly increased （ P 〈0.05）, and cardiac functional grading was more serious. After treatment, the detection value of NT-BNP was significantly improved （ P 〈 0.05） , and NT-BNP value was declined, and there were more improved symptoms patients with coronary heart disease （ P 〈0.05）. The older the patient was, the worse the improvement of coronary heart disease symptoms was （ P 〈0.05）. Conclusion Patients with chronic heart failure in mountainous areas have more severe symptoms, they usually complicated with hyperlipidemia, hypertension, diabetes, and symptoms show a closely relation with detection value of NT-BNP.