探讨血浆NT-proBNP水平对急性心力衰竭患者预后的临床意义

To Investigate Clinical Significance of Serum NT-proBNP Level on the Prognosis Inacute Heart Failurepatients

目的评估急性心力衰竭患者NT-proBNP水平与呼吸机使用及疾病转归的关系,初步探讨NT-proBNP水平对急性心力衰竭患者预后的预测作用。方法选取2015年4月至2017年3月因急性心力衰竭入住我院心内科的患者307例,入院后3h内急抽血查血浆NT-proBNP,据NT-proBNP水平将患者分为3组:A组:NT-proBNP<5000 pg/μL,B组:5000 pg/μL<NT-proBNP<10000 pg/μL,C组:10000NT-proBNP15000 pg/μL。随后跟踪患者住院期间使用呼吸机辅助通气及疾病转归情况,分析其与患者NT-proBNP之间的关系。选取我院体检中心健康人100例做正常对照组。结果急性心力衰竭患者NTproBNP水平明显升高,与健康人比较差异有统计学意义(P<0.05)。307例急性心力衰竭患者,33例曾使用呼吸机辅助通气治疗,25例住院期间死亡。3组患者呼吸机使用率及住院期间死亡率不同,C组明显高于A组和B组,差异有统计学意义(P<0.05)。结论 NT-proBNP水平越高,需要呼吸机辅助通气的几率越高,同时其住院期间死亡率也越高。NT-proBNP水平对急性心力衰竭患者病情严重程度及疾病转归具有预测作用。

Objective To study the relationship between plasma NT-proBNPleveland the use of ventilators andthesequelae of acute heart failure(AHF)patients,thus to assess the effect of NT-proBNP level on the prognosis of AHFpreliminary.Methods 307 patients with AHFin our hospital department of cardiology,from April 1 st,2015 to March 31 th,2017,are admitted to our study.Bloodcollectionforplasma NT-proBNPis carried out within 3 hours after admission.According to the NT-proBNP level,patients are divided into 3 groups:Group A:NT-proBNP<5000 pg/μL,GroupB:5000 pg/μL<NT-proBNP<10000 pg/μL,and Group C:10000 NT-proBNP15000 pg/μL.Then follow up the patient’s use of ventilator-assisted ventilationand the sequelae during hospitalization.And then analyze the effectof NT-proBNP level on the prognosis of AHF patients.100 cases of healthy people in ourmedicalexamination center are admitted as normal control group.Results The level of NT-proBNP in patients with AHFisincreased significantly,and the difference is statistically confirmed whencompared with healthy people.In 307 patients with AHF,33 have been treated with ventilator-assisted ventilation,and 25 die during hospitalization.The use of ventilators and the mortality ratein three groups are different,and Group C is significantly higher than that in Group A and Group B(P<0.05).Conclusion The higherlevel of NT-proBNP,the moreuseof ventilator-assisted ventilation,and the higher mortality rate during hospitalization.The NT-proBNP level has a predictive effect ontheseverityand the sequelaein patients with AHF.