联合监测无创血流动力学和脑钠肽评估妊娠高血压病患者心功能的价值

Value of combined detection of noninvasive hemodynamics and brain natriuretic peptide in evaluating cardiac function of patients with gestational hypertension

目的探讨联合监测无创血流动力学和脑钠肽(BNP)评估妊娠高血压病患者心功能的价值。方法256例妊娠高血压病患者按疾病分类标准分为妊娠高血压组(A组,82例)、子痫前期轻度组(B组,88例)和子痫前期重度组(C组,86例),另取同期正常妊娠孕妇82例为对照组(D组)。入院后采用PeriCare无创血流动力学检测仪监测无创血流动力学参数,同时测定血清BNP,比较各组无创血流动力学参数与BNP水平,分析无创血流动力学参数与BNP的相关性。结果C组BNP、SBP、DBP、MAP、外周血管阻力(SVR)、外周血管阻力指数(SVRI)和胸液水平(TFC)高于A、B、D组(P<0.05),心输出量(CO)、心脏指数(CI)低于A、B、D组(P<0.05)。A、B、D组HR、BNP、SBP、DBP、MAP、CO、CI、每搏输出量(SV)、每搏输出量指数(SVI)、SVR、SVRI、TFC、左心做功和左心做功指数均无统计学差异(P>0.05)。C组BNP与CO、CI、SV、SVI呈负相关(r=-0.764、-0.687、-0.807、-0.751,P<0.01),与SVR、SVRI呈正相关(r=0.741、0.636,P<0.01)。结论联合监测无创血流动力学和BNP能及时发现妊娠高血压病患者心功能异常,指导其诊断和治疗。

Objective To explore the value of combined detection of noninvasive hemodynamics and brain natriuretic peptide(BNP)in evaluating cardiac function of the patients with gestational hypertension.Methods The noninvasive hemodynamic monitoring was performed by PeriCare in 82 women with gestational hypertension(group A),88 women with mild preeclampsia(group B),86 women with severe preeclampsia(group C)and 82 normal pregnant women(group D).Serum BNP was measured in all the patients of 4 groups as well.The hemodynamic parameters and BNP levels were compared among the 4 groups.The correlation between hemodynamic parameters and BNP was analyzed.Results BNP,SBP,DBP,MAP,peripheral vascular resistance(SVR),SVR index(SVRI)and thoracic fluid content(TFC)were higher,while cardiac output(CO)and cardiac index(CI)were lower in group C than those in groups of A,B and D(P<0.05).There were no significant differences in HR,BNP,SBP,DBP,MAP,CO,CI,stroke volume(SV),SV index(SVI),SVR,SVRI,TFC,left cardiac work and left cardiac work index among groups of A,B and D(P>0.05).BNP was negatively correlated with CO,CI,SV and SVI(r=-0.764,-0.687,-0.807,-0.751,P<0.01)and positively correlated with SVR and SVRI in group C(r=0.741,0.636,P<0.01).ConclusionCombined detection of noninvasive hemodynamics and BNP can timely guide the diagnosis and treatment of abnormal cardiac function in the patients with gestational hypertension.