N末端脑利钠肽原对老年慢性心力衰竭患者预后的影响

目的探讨N末端脑利钠肽原（Nt—proBNP）水平对老年慢性心力衰竭（CHF）患者预后的影响。方法老年CHF患者115例为研究对象。心血管事件组65例，非心血管事件组50例，将心血管事件组进一步分为死亡组（21例）与非死亡组（44例），比较不同组间Nt—proBNP、左室舒张末期内径、左室射血分数。结果随着心功能下降，Nt—proBNP水平增高，各组间比较，差异有统计学意义（均P〈0．05）；心血管事件组的Nt—proBNP基线水平高于非心血管事件组（P〈0．05）；Nt—proBNP水平在死亡组高于非死亡组（P〈0．01），Nt—proBNP与是否发生事件明显相关。结论老年CHF患者Nt—proBNP水平增高，且随着心功能下降递增；血浆Nt—proBNP是预测老年CHF患者1年内发生心血管事件或死亡的良好指标。

A prospective clinical study of Nt-proBNP impact on the prognosis in the aged patients with chronic heart failure

Objective To evaluate the value of N-terminal-pro-brain （Nt-proBNP） in predicting death or hospital readmission after hospital discharge in the aged（ elder than 65 years old） patients with chronic heart failure （CHF）. Method A total of 115 CHF patients were included in the study, 65 cases of cardiovascular group and 50 cases of non-cardiovascular group. And the cardiovascular group was divided into death group and survive group. We compared the Nt-proBNP, left ventricular end-diastolic dimension and left ventrieular ejection fraction. Result （ 1 ） The concentration of Nt-proBNP increased with the decreasing of the cardiac function, the difference of each group was statistically significant （ P 〈 0. 05 ） ; （ 2 ） The Nt-proBNP concentration of cardiovascular group was higher than that of non-cardiovascular group （ P 〈 0. 05 ） ; （3） The Nt-proBNP concentration in death group was higher than that in survive group （P 〈 0.01 ）, Nt-proBNP was significantly related to the events-occurring. Conclusion Nt-proBNP level at admission is a strong predictor of rehospitalization and death within 12 months after hospital discharge in the aged patients with CHF.