B-型利钠肽对老年心功能不全患者预后的临床意义

目的探讨血浆B-型利钠肽水平对老年心功能不全患者预后的意义.方法测定112例心功能不全者血浆B-型利钠肽水平和左心室射血分数(LVEF).结果老年心功能不全者心功能分级与血浆B-型利钠肽对数值呈正相关(r=0.470,P=0.001),B-型利钠肽对数值与LVEF呈负相关(r=-0.499,P=0.001);心脏终点事件与B-型利钠肽对数值、LVEF、心功能分级呈正相关,分别为:t=5.745,P=0.001;t=2.294,P=0.024;χ2=27.32,P=0.001;采用非条件回归分析时,只有B-型利钠肽对数值和心功能分级与心脏终点事件呈正相关,P分别为0.006和0.005;血浆BNP>480 pg/ml时,对心脏终点事件预测灵敏度71.9%,特异度72.5%,阳性预测率为51.1%.结论血浆高水平BNP对老年心功能不全者是独立的危险因素,能预测近期心脏终点事件.

The clinical significance of b-type natriuretic peptide in prognosis in aged patients with cardiac dysfunction

Objective To analyze the significance of plasma B-type natriuretic peptide(BNP) level in prognosis in aged patients with cardiac dysfunction.Method To measure the plasma level of BNP and the left ventricular ejection fraction (LVEF) of 112 patients with cardiac dysfunction.Results The analysis of multinomial logistic regression:There is only obvious positive correlation between the heart end points occurrence and the BNPlg(BNP logarithm),NYHA class,(P=0.006,P=0.005 ).When the cutoff value of BNP is more than 480pg/ml, the sensitivity in prognosis of heart end points occurrence is 71.9%,the specificity is 72.5%,the positive predictive value is 51.1%.Conclusion High level of plasma BNP of the aged patients with cardiac dysfunction was a independent risk factor which possibly predicts the recent heart end points occurrence.