【摘要】 目的探讨尿BNP(brain natriuretic peptide)联合血H-FABP(heart fatty acid binding protein)及Nexilin水平检测在评估重症心衰患者预后心功能改善情况中的价值。方法选取我院心血管内科收治的重症心力衰竭患者并进行1年随访研究;按照随访结局将所有患者分为随访心功能不良组和随访心功能良好组。每位受试者取10mL静脉血样本及5mL尿液样本;尿BNP、血BNP、血H-FABP及Nexilin水平均采用ELISA法进行检测;心功能评估的指标包括心输出量、心脏指数、射血分数、肺动脉楔压及中心静脉压。结果本研究共获得符合要求的受试者175例。其中随访预后心功能不良者85例,预后心功能良好者90例;对比两组受试者的尿BNP、血BNP、血H-FABP及Nexilin水平,差异具有统计学意义,随访心功能不良患者进入研究队列时与治疗后尿BNP、血BNP、血H-FABP及Nexilin水平比较,差异有统计学意义(均P<0.05)。尿BNP、血BNP、血H-FABP及Nexilin水平与心功能评估各指标的相关性分析结果显示,心输出量与尿BNP、血BNP、Nexilin水平呈统计学负相关(P<0.05);心脏指数、射血分数与尿BNP、血BNP、血H-FABP及Nexilin水平呈统计学负相关(P<0.05);并联诊断结果曲线下面积为0.878,95%CI:0.803～0.958,串联诊断结果曲线下面积为0.609,95%CI:0.523～0.701。结论尿BNP、血BNP、血H-FABP及Nexilin水平的上升对重症心力衰竭预后不良的早期诊断具有一定价值,尿BNP联合血H-FABP及Nexilin水平检测在评估重症心衰患者预后心功能改善情况中的价值相对更大。更多还原

【Abstract】 Objective To evaluate the value of urinary BNP level combined with blood H-FABP and Nexilin in the evaluation of prognosis cardiac function in patients with severe heart failure.Methods We selected patients with severe heart failure admitted to our department of cardiology for the study,and conducted a one-year follow-up study.The studied patients were divided into the poor cardiac function group and the good cardiac function group according to the follow-up outcomes.10 mL venous blood samples and 5 mL urine samples were taken from each subject.The content of urine BNP,blood H-FABP and Nexilin were detected by ELISA.The cardiac function indicators including cardiac output,cardiac index,ejection fraction,pulmonary wedge pressure and central venous pressure were assessed.Results A total of 175 eligible subjects were obtained in this study.Among them,85 patients with poor cardiac function and 90 patients with good cardiac function were followed up.There were significant differences in urinary BNP,blood H-FABP and Nexilin levels between the two groups.There were significant differences in urinary BNP,blood H-FABP and Nexilin levels among the subjects with different prognostic conditions.Also,there were significant differences in urinary BNP,blood H-FABP and Nexilin levels between baseline and follow-up in patients with poor prognosis of cardiac function(P<0.05).The correlation analysis of urinary BNP,blood H-FABP and Nexilin content and cardiac function evaluation indicators showed that cardiac output was negatively correlated with urinary BNP and Nexilin content(P<0.05),while the cardiac index and ejection fraction were negatively correlated with urinary BNP,blood H-FABP and Nexilin(P<0.05).The area under curve of the parallel diagnosis result was 0.7878,with 95% CI:0.803-0.958,and the area under curve of the tandem diagnostic result was 0.609,with 95% CI:0.523-0.701.Conclusion The increase of urinary BNP,blood H-FABP and Nexilin content has certain value in the early diagnosis of severe heart failure.Parallel urinary BNP levels combined with blood H-FABP and Nexilin levels are of greater value in assessing prognostic of cardiac function improvement in patients with severe heart failure.更多还原