【摘要】 目的探讨氨基末端脑利钠肽前体(NT-proBNP)对慢性心力衰竭(CHF)患者心功能的评估价值。方法收集宜兴市人民医院2013年1月至2015年6月期间住院治疗的无影响因素的CHF患者830例进行回顾性分析,将830例CHF患者按照NYHA心功能分级标准(Ⅰ～Ⅳ级)进行分级,其中心功能I级70例,II级137例,III级270例,IV级353例。按中华医学会推荐的心力衰竭指南治疗,比较不同心功能分级患者治疗前及治疗后半个月全血NT-proBNP浓度及NYHA心功能分级的变化。随访患者出院后6个月及1年的终点事件(心力衰竭再住院和心力衰竭死亡)发生情况,相关分析分析患者出院后6个月及1年终点事件与NT-proBNP值高低的相关性。结果随着心功能级别升高NT-proBNP含量增高,心功能分级与治疗前NT-proBNP呈正相关; NT-proBNP与心力衰竭终点事件(心力衰竭再住院和心力衰竭死亡)呈正相关,发生不良的患者全血NT-proBNP含量明显高于未发生不良的患者,差异具有统计学意义(P <0. 05);患者治疗后半个月相同心功能分级的全血NT-proBNP水平较治疗前明显降低,差异具有统计学意义(P <0. 05)。结论 NT-proBNP浓度变化对心力衰竭患者诊断、治疗、危险分层及终点事件预测具有较高的临床价值。更多还原

【Abstract】 Objective To study the effect of N-terminal pro brain natriuretic peptide( NT-proBNP) on chronic heart failure( CHF) evaluation of cardiac function in patients. Methods From January 2013 to June 2015 in our hospital department of cardiology hospital treatment with no effect on heart function factors in all 830 patients with CHF were analyzed,830 patients with cardiac heart failure and recovery of heart function classification NYHA( I ～ IV) classification,the central function of I level 70 cases,cardiac function II level 137 cases,cardiac function III level 270 cases,cardiac heart function IV level 353 cases. According to the guidelines for the treatment of cardiac heart failure,recommended by the Chinese Medical Association,the changes of the whole blood NT-proBNP concentration and NYHA cardiac function classification were compared between the two groups before and after treatment. At the end of 6 months and years after discharge,months after discharge and 1 year mortality in patients with cardiac heart failure,and the correlation between 6 months and 1 year end events and NT-proBNP value of patients after discharge from hospital were analyzed. Results Patients with cardiac heart function and the content of NT-proBNP increased,cardiac heart function before treatment with NT-proBNP were positively correlated. NT-proBNP was positively correlated with the end point events( heart failure readmission and death) of cardiac heart failure,and the NT-proBNP content of whole blood was significantly higher than that of the patients who did not,the difference was statistically significant( P < 0. 05). the blood NT-proBNP level of patients with same classification decreased significantly after half month,the difference was statistically significant( P < 0. 05). Conclusion The change of NT-proBNP concentration has a good predictive value for the diagnosis,treatment,risk stratification and terminal event in patients with cardiac heart failure.更多还原