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目的:观察妊娠合并心脏病孕妇血清NT-proBNP在妊娠过程中的动态变化及探讨妊娠过程中NT-proBNP的水平与妊娠合并心脏病孕妇发生不良心脏事件的关系。方法:前瞻性研究128例妊娠合并心脏病孕妇在妊娠过程中NT-proBNP的动态变化,并取同期52例正常妊娠的孕妇作为对照组;获取孕妇在孕早期、孕晚期及产后6周的临床资料及相应的血清NT-proBNP数值,分析BNP在妊娠合并心脏病孕妇中的变化与妊娠过程中不良心脏事件发生的相关性。结果:妊娠合并心脏病孕妇血清NT-proBNP浓度为86(65～189)pg/ml,高于正常妊娠孕妇46(31～59)pg/ml(P<0.05),并在孕期进行性升高。在妊娠合并心脏病孕妇中有左室功能障碍患者的BNP水平明显高于没有左室功能障碍的患者,BNP≤100 pg/ml可以作为排除患者孕期发生不良心脏事件的良好的阴性指标之一。结论:妊娠合并心脏病孕妇在孕期随着心脏功能的下降BNP水平进行性升高,因此监测此类患者BNP在临床实践中对病情的观察有一定的指导意义,特别在判断有否可疑不良心脏事件的发生上有重要的作用。
Objective: To observe the dynamic changes of serum NT-proBNP in pregnant women with pregnancy complicated with heart disease during pregnancy and to explore the relationship between the level of NT-proBNP during pregnancy and adverse cardiac events in pregnant women with heart disease. Methods: A prospective study of dynamic changes of NT-proBNP in pregnant women with pregnancy complicated with heart disease during pregnancy was conducted in a prospective study. Fifty-two pregnant women with normal pregnancy were enrolled in this study. Pregnant women were enrolled in the first trimester of pregnancy, the third trimester of pregnancy and six weeks postpartum Data and the corresponding serum NT-proBNP values, analysis of BNP in pregnant women with pregnancy complicated with heart disease and pregnancy related adverse cardiac events. Results: The NT-proBNP concentration in pregnant women with heart disease was 86 (65-189) pg / ml, which was higher than that of 46 (31-59) pg / ml pregnant women with normal pregnancy (P <0.05) . BNP levels in patients with left ventricular dysfunction in pregnant women with heart disease complicated with heart disease are significantly higher than those without left ventricular dysfunction. BNP≤100 pg / ml may be one of the good negative indicators to exclude adverse cardiac events during pregnancy. Conclusion: Pregnant women with heart disease during pregnancy have a progressive increase in BNP levels during pregnancy. Therefore, it is instructive to monitor these patients’ BNP status in clinical practice, especially in judging whether there is a suspicious adverse cardiac The occurrence of the incident has an important role.