论文部分内容阅读
目的:通过快速床旁检测心力衰竭患者血中脑钠素(BNP),对比研究BNP对心力衰竭患者早期诊断、危险分层及预后评价的价值。方法:入选2002年7月～2003年2月心力衰竭患者32例,非心力衰竭患者(心功能NYHAⅠ级)13例。即刻床旁抽血查血浆BNP浓度并行心脏超声检查。同时观察入院时血压、心率、肺部罗音和住院期间及出院后一个月内不良事件。结果:(1)冠心病、高血压、风心病导致的心力衰竭患者的血浆BNP浓度都明显增高,但互相之间无明显差别;(2)BNP浓度增高程度与心力衰竭的严重程度成正相关;(3)BNP与左室射血分数(LVEF)呈显著负相关(相关系数为-0.76,P值<0.001),与左室舒张末径(LVDD)呈显著正相关(相关系数为0.699,P值<0.001)。(4)BNP值为97.5pg/ml时,其预测心力衰竭的敏感性为90.6％,特异性为100％。(5)BNP浓度严重升高患者,死亡率及再住院率明显升高。结论:快速床旁检测血浆中BNP浓度是早期诊断心力衰竭的一项重要的检查手段;血浆BNP浓度高低可能是对心力衰竭患者进行危险分层及预后评价的一项重要指标。
Objective: To evaluate the value of BNP in heart failure patients by rapid bedside test and to compare the value of BNP in early diagnosis, risk stratification and prognosis of patients with heart failure. Methods: Thirty-two patients with heart failure from July 2002 to February 2003 were enrolled. Thirteen patients with non-heart failure (NYHA class Ⅰ cardiac function) were enrolled. Immediate blood pumping to check the plasma BNP concentration and cardiac echocardiography. Adverse events such as blood pressure, heart rate, pulmonary rales, hospitalization during hospitalization and within one month after discharge were also observed. Results: (1) Plasma BNP levels in patients with heart failure caused by coronary heart disease, hypertension and rheumatic heart disease were significantly increased, but there was no significant difference between them. (2) The level of BNP was positively correlated with the severity of heart failure. (3) There was a significant negative correlation between BNP and left ventricular ejection fraction (LVEF) (correlation coefficient -0.76, P <0.001), and positively correlated with left ventricular diastolic diameter (LVDD) (correlation coefficient 0.699, P Value <0.001). (4) When the BNP value was 97.5 pg / ml, the sensitivity and specificity of predicting heart failure were 90.6% and 100% respectively. (5) Patients with severe BNP concentration increased mortality and rehospitalization rate significantly. CONCLUSIONS: Rapid bedside testing of plasma BNP concentration is an important diagnostic tool for early diagnosis of heart failure. Plasma BNP concentration may be an important indicator of risk stratification and prognosis in patients with heart failure.