早发型重度子痫前期患者心功能分级及左心室功能与血清脑利钠肽水平的相关性

Relationship between the cardiac function classification and left ventricular function of pregnant women with early-onset severe preeclampsia and their serum brain natriuretic peptide level

目的:探讨早发型重度子痫前期患者心功能分级(NYHA)及左心室功能与血清脑钠肽水平的相关性。方法:选择2015年3月—2016年3月本院收治的早发型重度子痫前期患者55例(观察组),分别为NYHAⅠ~Ⅱ级组(32例)和NYHAⅢ~Ⅳ组(23例);另选同期正常中晚期妊娠孕妇55例为对照组。均检测血清脑利钠肽(BNP),超声心动图检测左室舒张末内径(LVIDd),左室收缩末内径(LVIDs)、右房内径(RVDd)、左室射血分数(LVEF),观察各指标差异,分析血清BNP与NYHA、LVEF相关性。结果:观察组LVIDs、血清CK、CK-MB、LDH、NT-ProBNP水平高于对照组,LVEF低于对照组,且NYHAⅠ~Ⅱ级孕妇LVIDs、血清CK、CK-MB、LDH、NT-ProBNP水平低于NYHAⅢ~Ⅳ级孕妇,LVEF大于NYHAⅢ~Ⅳ级孕妇(均P<0.05)。相关性分析,血清BNP水平与LVEF呈负相关(r=-0.561,P=0.000),与NYHA呈正相关(r=0.432,P=0.002)。结论:早发型重度子痫前期患者血清BNP水平偏高,高水平BNP与心功能和左心室射血功能降低有关。

Objective:To investigate the correlation between serum brain natriuretic peptide(BNP)level of pregnant women with early-onset severe preeclampsia and their cardiac function classification and left ventricular function.Methods:55 women with early-onset severe preeclampsia were selected in study group and were divided into group A(women with NYHA I-II cardiac function)and group B(women with NYHA II-IV cardiac function)according to the New York Heart Association(NYHA)cardiac function classification from March 2015 to March 2016.55 normal pregnant women were selected in the control group during the same period.The serum brain natriuretic peptide(BNP)level,the values of left ventricular end-diastolic diameter(LVIDd),left ventricular end-systolic diameter(LVIDs),right atrial diameter(RVDd),and left ventricular ejection fraction(LVEF)by echocardiographic examination of women in these groups were examined and their differences were observed.The correlation between the serum BNP level and the values of NYHA and LVEF was analyzed.Results:The LVIDs value,and the levels of serum CK,CK-MB,LDH,and NT-ProBNP of women in the study group were significant higher than those of women in the control group,but the LVEF value of women in the study group was significant lower.The LVIDs value,and the levels of serum CK,CK-MB,LDH,and NT-ProBNP of women in group A were significant lower than those of women in the control group,but the LVEF value of women in group A was significant higher(all P<0.05).Correlation analysis showed that serum BNP level was negatively correlated with LVEF value(r=-0.561,P=0.000)and was positively correlated with NYHA value(r=0.432,P=0.002).Conclusion:Serum BNP level of pregnant women with early-onset severe preeclampsia is high,and the high BNP level is associated with the cardiac function and left ventricular ejection function decreased.