【摘要】 目的　探讨快速测定脑利钠肽预测充血性心力衰竭近期预后的价值。方法　 70例充血性心力衰竭住院患者 ,NYHA心功能Ⅲ级 3 7例、Ⅳ级 3 3例。入院时、出院前或临终前 2 4小时内分别测定血浆BNP ,分析住院治疗前后BNP水平变化与心源性死亡、3 0天内再住院事件的关系。结果　 2 3例患者出现终点事件 (因心功能恶化死亡 6例、再住院 17例 ) ,其入院时BNP水平 ( 15 16pg/ml± 872pg/ml)高于未发生临床终点者 ( 10 3 7pg/ml± 65 4pg/ml) ,P <0 .0 1;发生临床终点者住院期间BNP升高 3 18pg/ml ,而未发生终点事件的患者 ,住院期间BNP平均降低 3 5 9pg/ml ,P <0 .0 1;BNP升高组患者发生临床终点 68.2 % ,BNP降低组患者发生临床终点 16.7% ,P <0 .0 0 5。结论　BNP水平可预测失代偿充血性心力衰竭患者的近期预后更多还原

【Abstract】 Objective To evaluate the prognostic value of rapid measurement plasma brain natriuretic peptide(BNP) in patients admitted with congestive heart failure(CHF).Methods we followed 70 patients admitted with New York Heart Association class Ⅲ to Ⅳ CHF,whose BNP were measured with rapid bedside assay,and evaluated the association between the changes in BNP levels during treatment and subsequent adverse outcomes(death and 30-day readmission).Results Of the 70 patients admitted with CHF,23 end points occurred (cardiac death:n=6,readmission:n=17).BNP levels in bad outcomes and good outcomes were 1516pg/ml±872pg/ml and 1037pg/ml±654pg/ml,respectively(P<0.01).BNP levels in patients with end points increased during hospitalization (mean increase,318 pg/ml),In patients without end points,BNP decreased (mean decrease, 359pg/ml),P<0.01.And 22 patients with BNP increased had end points rate 68.2%,48 patients with BNP decreased had 16.7%,P<0.005.Conclusions Changes in BNP levels during treatment are strong predictors for mortality and early readmission.The results suggest that BNP levels might be used efficiently to guide treatment of patients admitted for CHF and estimate the prognosis.更多还原