心力衰竭患者血清B型脑钠肽和左心室射血分数变化情况及对患者预后的预测价值

摘要

目的 探究心力衰竭患者血清B型脑钠肽(BNP)和左心室射血分数(LVEF)变化情况对患者预后的预测价值.方法 选取2015年1月至2016年12月河北大学附属医院收治的心力衰竭患者93例.根据纽约心脏病协会心功能分级,将患者分为Ⅱ级组(21例)、Ⅲ级组(52例)、Ⅳ级组(20例).全部患者均接受抗心力衰竭治疗.对比分析患者治疗前后血清BNP水平和LVEF,对治疗后的患者进行为期1年的随访,统计再入院患者数和死亡患者数,对比不同结局患者的治疗后血清BNP水平.结果 经过治疗,3组患者的血清BNP水平均降低,LVEF均增高,与治疗前比较差异均有统计学意义(均P＜0.05).在治疗前与治疗后,随着心功能分级的升高,患者血清BNP水平逐渐升高,LVEF数值逐渐减小(均P＜0.05).完成治疗后1年内,40例患者再次入院,5例患者死亡,再次入院患者在本次治疗后血清BNP水平高于1年内未入院的患者,死亡患者本次治疗后血清BNP水平高于生存患者[(943±276) ng/L比(785±230) ng/L、(998±294) ng/L比(615±287) ng/L],差异均有统计学意义(t=3.016,P=0.003;=2.903,P=0.005).结论 血清BNP联合LVEF可以客观反映心力衰竭患者的心功能情况,其中血清BNP对心力衰竭患者的预后有较高的预测价值.%Objective To observe the changes of serum B-type natriuretic peptide (BNP and left ventricular ejection fraction(LVEF) in patients with heart failure and to analyze their predictive values for the prognosis.Methods Ninety-three patients with heart failure admitted to Affiliated Hospital of Hebei University from January 2015 to December 2016 were enrolled.According to the New York Heart Association cardiac function classification,the patients were divided into grade]] group(21 cases),grade Ⅲ group(52 cases) and grade ⅣV group(20 cases).All patients had anti-heart failure treatment.Levels of serum BNP and LVEF were detected before and after treatment.Re-admission and death were recorded in 1 year after discharge;serum BNP level was analyzed among patients with different outcomes.Results After treatment,serum BNP level decreased and LVEF increased compared to those before treatment (all P ＜ 0.05).Before and after treatment,serum BNP level increased and LVEF decreased among grade Ⅱ,grade Ⅲ and grade Ⅳ groups(all P ＜0.05).Within 1 year after treatment,40 patients were re-admitted and 5 patients died.Patients with re-admission had higher serum BNP level than those who were not admitted to hospital within 1 year;serum BNP level of patients who died within 1 year were higher than that of the survivors [(943 ± 276) ng/L vs (785 ± 230) ng/L,(998 ± 294) ng/L vs (615±287)ng/L](t =3.016,P=0.003;t =2.903,P=0.005).Conclusion Serum BNP combined with LVEF can reflect the cardiac function of patients with heart failure;serum BNP has a high predictive value for the prognosis of heart failure.