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目的观察心力衰竭患者血清B型利钠肽(BNP)水平变化,探讨其临床意义。方法选取2013年6月—2015年3月宜昌市中心人民医院收治的心力衰竭患者80例,按照美国纽约心脏病协会分级(NYHA)标准分为Ⅰ级30例,Ⅱ级22例,Ⅲ级18例,Ⅳ级10例。检测患者血清BNP水平、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD),分析血清BNP水平与心功能分级的关系。结果随着心功能分级增大,血清BNP水平升高(P<0.05),二者呈正相关(r=0.673,P<0.05)。LVEF≤0.5患者血清BNP水平高于LVEF>0.5患者(P<0.05),二者呈负相关(r=-0.824,P<0.01)。LVEDD>55 mm患者血清BNP水平高于LVEDD≤55 mm患者(P<0.05),二者呈正相关(r=0.513,P=0.04)。心源性死亡、心源性再入院患者血清BNP水平均高于无再发事件患者(P<0.05)。结论血清BNP水平可准确反映心力衰竭患者心功能,对心力衰竭的早期诊断及预后评估均具有重要临床价值。
Objective To observe the changes of serum level of B-type natriuretic peptide (BNP) in patients with heart failure and to explore its clinical significance. Methods Eighty patients with heart failure admitted to Yichang Central People’s Hospital from June 2013 to March 2015 were divided into three groups according to the New York Heart Association classification (NYHA): grade Ⅰ (n = 30), grade Ⅱ (n = 22), grade Ⅲ Cases, Ⅳ grade 10 cases. The levels of serum BNP, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were measured. The relationship between serum BNP level and cardiac function was analyzed. Results With the increase of cardiac function, the level of serum BNP increased (P <0.05), and there was a positive correlation between them (r = 0.673, P <0.05). BNP levels in patients with LVEF≤0.5 were significantly higher than those with LVEF≥0.5 (P <0.05), and negative correlation was found between them (r = -0.824, P <0.01). The level of BNP in patients with LVEDD> 55 mm was significantly higher than those with LVEDD≤55 mm (P <0.05), and the positive correlation was found between them (r = 0.513, P = 0.04). Cardiac BNP levels in patients with cardiogenic death and cardiac hospital admission were significantly higher than those without recurrence (P <0.05). Conclusions Serum BNP levels can accurately reflect the heart function in patients with heart failure, and have an important clinical value in early diagnosis and prognosis of heart failure.