血清N-端脑钠肽前体在慢性心力衰竭预后评价中的应用价值分析

摘要

Objectives To investigate the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in prognosis of patients with Chronic heart failure (CHF).Methods Eighty CHF patients were selected from January 2012 to December 2013 in Department of Cardiology, Longyan First Hospital Affiliated to Fujian Medical University, and divided into low level group (n=26), medium level group (n=24), and high level group (n=30) based on level of NT-proBNP at the day of admission. All three groups received conventional treatment. Serum NT-proBNP level was compared before and after treatment in three groups and in patients with different heart functional class. Correlation of serum NT-pro BNP level and cardiac function classification were analyzed. The relationship between NT-proBNP levels with rehospitalization and mortality was analyzed in three groups during the follow-up period.Results After treatment, the levels of NT-proBNP were significantly decreased in the three groups and the patients with different grades of cardiac function. The difference was statistically significant (P<0.05). There was a significant positive correlation between NT-proBNP and cardiac function (r=0.71,P<0.001). During the follow-up period, the re-hospitalization rates were 7.69%, 25.00% and 36.67% in the low, medium and high-level groups, respectively, with mortality rates of 3.85%, 20.83% and 40.00%, respectively. The rates of rehospitalization and mortality in the three groups were statistically significant (P<0.05). There was a significant positive correlation between serum NT-proBNP and CHF re-hospitalization rate (r=0.54,P<0.001) and mortality (r=0.47,P<0.001). Conclusion The serum NT-proBNP level was positively correlated with CHF patients' cardiac function grade, re-hospitalization rate and mortality rate. By monitoring serum NT-proBNP level, we could not only grasp the severity of CHF, but also accurately evaluate the prognosis of patients.%目的：分析血清N-端脑钠肽前体（NT-proBNP）在慢性心力衰竭（CHF）预后评价中的应用价值。方法选择2012年1月~2013年12月于福建医科大学附属龙岩市第一医院心血管内科接受治疗的CHF患者80例，依据入院当天测定NT-proBNP情况将患者分为低水平组（n=26），中水平组（n=24），高水平组（n=30）。三组均行常规治疗。观察比较三组及不同心功能分级患者治疗后血清NT-proBNP水平，血清NT-proBNP水平和心功能分级之间的相关性。分析随访期间，三组再住院及死亡情况，血清NT-proBNP水平与再住院率、死亡率之间的相关性。结果治疗后，三组以及不同心功能分级患者血清NT-proBNP水平均显著降低，与治疗前差异有统计学意义（P＜0.05）。血清NT-proBNP水平与心功能分级呈现显著正相关（r=0.71，P＜0.001）。随访期间，低、中、高水平组再住院率分别为7.69%、25.00%、36.67%，死亡率为3.85%、20.83%、40.00%，三组再住院率、死亡率差异有统计学意义（P＜0.05）。血清NT-proBNP水平与CHF患者再住院率（r=0.54，P＜0.001）、死亡率（r=0.47，P＜0.001）存在显著的正相关。结论血清NT-proBNP水平与CHF患者心功能分级、再住院率、死亡率存在正相关关系，通过监测血清NT-proBNP水平不但能够掌握患者CHF的严重程度，还可准确评估患者预后。