血浆脑钠素水平在心血管病患者中的预后意义

目的探讨血浆脑钠素(BNP)水平对心血管病人全因死亡率的影响,及BNP对患者的预后意义。方法解放军总医院第一附属医院2003年9月至2005年6月期间的住院患者,均有心脏病史,共275例,随访2年,失访2例。根据BNP水平分为3组:BNP<100ng/L,101～1000ng/L,>1000ng/L,比较各组间死亡率的差别,绘制生存曲线。结果随访期间,共死亡42例患者,心源性死亡25例,非心源性死亡17例。3组比较,各组间死亡率比较有统计学意义(P<0.001),随BNP浓度的增加,死亡率逐渐升高。在多因素比较中,年龄和BNP有统计学意义,相对于BNP>1000ng/L,各组BNP对死亡影响的危险比值均<1,说明BNP是影响患者预后的独立危险因素。结论BNP水平是死亡危险增加的一个生化指标,是影响患者预后的一个独立危险因素。

Prognostic significance of plasma brain natriuretic peptide levels in patients with cardiovascular diseases

Objective To explore the influence of brain natriuretic peptide(BNP)level on mortality in patients with cardiovascular diseases.Methods A total of 275 patients with cardiovascular diseases were enrolled,and followed up for 24 months.They were divived into three groups according to the level of plasma BNP:gronp 1,BNP<100ng/L;gronp 2,BNP 101-1000ng/L;gronp 3,BNP>1000ng/L.All causes of mortality were examined in relation to BNP levels during follow up.Results Forty-two(15.3%)patients died during follow up.Twenfy five of them died of cardiac causes and 17 non-cardiac causes.The mortality among the 3 groups was different significantly(P<0.001).Cox regression analysis showed that BNP was the most significant predictor of all causes of mortality.Conclusion The plasma BNP concentration appears to be a biochemical marker of increased risk for all-cause mortality in patients with cardiovascular diseases.