血清BNP水平在心力衰竭分级中的预后及诊断意义

The prognostic and diagnostic significance of serum BNP level in the classification of heart failure

目的探讨血清BNP水平在心力衰竭分级中的预后及诊断意义。方法自2014年9月到2016年10月,对我院心血管内科收治的162例心力衰竭患者进行随访(心衰组),同时收集于我院体检科正常健康体检者162例(对照组)。检测心衰组和对照组患者血清中BNP水平,同时检查心力衰竭患者中左室射血分数(LVEF)。并比较血清BNP水平在不同类型心力衰竭患者和对照组中的差异。同时比较ACEI类药物治疗前后血清BNP水平的变化。结果心衰组患者BNP的浓度明显高于对照组(P<0.05)。血清BNP水平在有左心室收缩功能不全的患者中显著高于无左心室收缩功能不全的患者(P<0.01)。合并糖尿病的心力衰竭患者血清BNP水平显著高于非糖尿病患者(P<0.05),合并高血压的心力衰竭患者血清BNP水平显著高于非高血压患者(P<0.01)。不同年龄、性别及急慢性心力衰竭之间血清BNP水平无明显统计学差异。结论血清BNP水平可用于有无左室收缩性功能不全心力衰竭的判断,血清BNP水平可预测患者死亡率、再次返院情况及急性心血管事件发生情况。

Objective To explore the prognostic and diagnostic significance of serum BNP level in the classification of heart failure.Methods From September 2014 to October 2014,cardiovascular internal medicine in our hospital treated 162 cases of patients with heart failure in follow-up(heart failure group),collected in our hospital check-up also normal,healthy physical examination of 162 cases(control group).Serum BNP levels were detected in the heart failure group and control group,while the left ventricular ejection fraction(LVEF)was examined in patients with heart failure.The differences of serum BNP level in patients with different types of heart failure and control group were compared.At the same time,the changes of serum BNP level before and after treatment of ACEI drugs were compared.Results The concentration of BNP in the heart failure group was significantly higher than that in the control group(P<0.05).Serum BNP levels were significantly higher in patients with left ventricular systolic dysfunction(P<0.01)than those without left ventricular systolic dysfunction.The serum BNP level in patients with heart failure with diabetes mellitus is significantly higher than patients without diabetes(P<0.05),hypertension patients with heart failure serum BNP level was significantly higher than patients without hypertension(P<0.01).There was no significant difference in serum BNP level between different age,gender and acute and chronic heart failure.Conclusion Serum BNP level was associated with the severity of heart failure,and may serve as a potential biomarker in the diagnosis of diastolic and systolicheart failure as well as prognosis indicator of heart failure.