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目的探讨老年慢性心力衰竭患者脑钠肽检测的应用价值及脑钠肽变化对患者预后的评估价值。方法治疗前后236例慢性心力衰竭患者作为观察组,142例健康体检者作为对照组。比较两组脑钠肽水平及观察组不同心功能分级间脑钠肽水平。结果观察组脑钠肽水平为(592.3±16.4)pg/ml,高于对照组的(70.3±17.9)pg/ml,差异具有统计学意义(P<0.01)。治疗前,心功能Ⅰ级患者脑钠肽水平为(146.1±32.6)pg/ml、心功能Ⅱ级为(343.8±52.3)pg/ml、心功能Ⅲ级为(602.4±100.3)pg/ml、心功能Ⅳ级为(1042.7±72.6)pg/ml,脑钠肽水平随心功能分级增加而增高,比较差异具有统计学意义(P<0.05)。治疗后,心功能Ⅰ级脑钠肽水平为(68.2±14.4)pg/ml、心功能Ⅱ级为(126.2±22.1)pg/ml、心功能Ⅲ级为(187.4±26.1)pg/ml、心功能Ⅳ级为(224.6±37.2)pg/ml,治疗后不同心功能分级脑钠肽水平均低于治疗前,差异均具有统计学意义(P<0.05)。脑钠肽水平与心功能分级呈正相关性(r=0.847,P<0.05)。结论慢性心力衰竭患者脑钠肽检测水平显著高于健康人群,心功能分级与脑钠肽检测水平之间存在正相关关系,随着心力衰竭治疗的好转脑钠肽检测水平显著降低,因此脑钠肽水平可作为慢性心力衰竭的诊断、临床分级以及疗效判断的客观指标。
Objective To investigate the clinical value of brain natriuretic peptide (BNP) in elderly patients with chronic heart failure and the prognostic value of brain natriuretic peptide in patients with chronic heart failure. Methods 236 cases of patients with chronic heart failure before and after treatment as the observation group, 142 healthy subjects as a control group. The level of brain natriuretic peptide was compared between two groups and the levels of brain natriuretic peptide in different levels of cardiac function in the observation group. Results The brain natriuretic peptide level in the observation group was (592.3 ± 16.4) pg / ml, which was significantly higher than that in the control group (70.3 ± 17.9) pg / ml (P <0.01). Before treatment, the level of brain natriuretic peptide was (146.1 ± 32.6) pg / ml, the level of cardiac function was (343.8 ± 52.3) pg / ml and the level of cardiac function was (602.4 ± 100.3) pg / The level of cardiac function was (1042.7 ± 72.6) pg / ml. The level of brain natriuretic peptide increased with the increase of cardiac function. The difference was statistically significant (P <0.05). After treatment, the level of serum BNP Ⅰ was (68.2 ± 14.4) pg / ml, the level of cardiac function Ⅱ was (126.2 ± 22.1) pg / ml, the level of cardiac function Ⅲ was (187.4 ± 26.1) pg / The level of functional grade Ⅳ was (224.6 ± 37.2) pg / ml. The levels of brain natriuretic peptide with different cardiac function after treatment were all lower than those before treatment. The difference was statistically significant (P <0.05). Brain natriuretic peptide level was positively correlated with cardiac function classification (r = 0.847, P <0.05). Conclusions The serum brain natriuretic peptide level in patients with chronic heart failure is significantly higher than that in healthy people. There is a positive correlation between the level of cardiac function and the level of brain natriuretic peptide. With the improvement of heart failure, the level of brain natriuretic peptide is significantly decreased, Peptide levels can be used as an objective indicator of the diagnosis, clinical grade and efficacy of chronic heart failure.