血钠、尿酸、B型利钠肽与心力衰竭的相关性及其对患者生活质量的影响

The relationship between blood natrium, uric acid, BNP and heart failure and its influence on life quality of patient

目的探讨血钠、尿酸、B型利钠肽(B-type natriuretic peptide,BNP)与心力衰竭的相关性及对患者生活质量的影响。方法选取我院心力衰竭患者86例作为研究对象。参照美国纽约心脏病协会(New York heart disease association,NYHA)心功能分级将患者分为3组:A组(NYHAⅡ级,42例),B组(NYHAⅢ级,25例),C组(NYHAⅣ级,19例),组间比较血钠、尿酸、BNP水平与明尼苏达心力衰竭生活质量量表(Minnesota Living with Heart Failure Questionnaire,MLHFQ)评分的差异,直线相关性分析血钠、尿酸、BNP水平与心力衰竭NYHA心功能分级的关系,多重线性逐步回归分析心力衰竭患者生活质量的影响因素。结果血钠水平比较显示,A组>B组>C组,尿酸、BNP水平比较显示,A组<B组<C组,组间比较差异具有统计学意义(P<0.05);直线相关性分析显示,随着NYHA心功能分级的增加,血钠水平呈逐渐降低的趋势(r=-0.531,P<0.05)。尿酸、BNP水平呈逐渐增加的趋势(r=0.654,0.712,P<0.05)。A组MLHFQ量表各领域与总评分均明显低于B、C组,且B组上述评分明显低于C组,组间比较差异具有统计学意义(P<0.05)。多重线性逐步回归分析显示,NYHA心功能Ⅳ级、低血钠症、高尿酸血症、BNP阳性是影响心力衰竭患者生活质量的独立危险因素(r=0.495、0.513、0.503、0.498,P<0.05)。结论随着心力衰竭病情的加重,血钠水平呈降低趋势,而尿酸、BNP水平呈增高趋势,三者水平与心功能分级是影响心力衰竭患者生活质量的主要影响因素。

Objective To investigate the relationship between blood natrium, uric acid, B-type natriuretic peptide (BNP) and heart failure and its influence on life quality of patient. Methods 86 heart failure patients were selected as study objects in our hospital. According to New York heart disease association (NYHA), all patients were divided into three groups, group A (NYHA Ⅱ, 42 cases), group B (NYHA Ⅲ,25 cases), group C (NYHA Ⅳ,19 cases), the levels of blood natrium, uric acid, BNP and Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores were compared among groups, the lev-els of blood natrium, uric acid, BNP and NYHA were analyzed by linear correlation, influence factors of life quality on heart failure were analyzed by multiple linear stepwise regression analysis. Results Blood natrium level comparison showed that group A > group B > group C. Uric acid,BNP level comparison showed that group A < group B < group C, the difference was statistically significant (P<0.05). The linear correlation analysis showed that the blood natrium level was gradually decreasing with the increasing of NYHA grade (r=-0.531,P<0.05), but the uric acid, BNP levels were gradually increasing (r=0.654, 0.712, P<0.05). The MLHFQ in all areas and total scores of group A were significantly lower than group B and group C , that of group B were significantly lower than group C, the difference was statistically significant (P<0.05). Multiple linear stepwise re-gression analysis showed that NYHA grade, hyponatrcmia, hyperuricemia and BNP (+) were independent risk factors of life quality on heart failure (r=0.495, 0.513, 0.503, 0.498, P<0.05). Conclusion With the aggravation of heart failure, blood natrium level shows decreasing trend, while uric acid and BNP levels show increasing trend, and the above levels and cardiac function classification are the main independent factors of life quality on heart failure.