D-二聚体和P-选择素及B型钠尿肽的检测对于窦性心律心力衰竭患者的临床意义

目的通过检测窦性心律的慢性心力衰竭患者血浆中D-二聚体、P-选择素和B型钠尿肽(BNP)的水平,探索窦性心律心力衰竭患者抗凝、抗栓治疗的必要性及治疗的时机。方法选取窦性心律慢性心力衰竭患者68例。根据射血分数(EF)进行分组:A组EF≥45%,20例;B组45%EF35%,22例;C组EF≤35%,26例。分别测定血浆D-二聚体、P-选择素、BNP水平。结果 C组患者血浆D-二聚体(4.7±2.79)μg/m L比(3.01±1.15)μg/m L]、P-选择素(17.2±2.4)μg/L比(14.6±3.7)μg/L]、BNP(1347.8±158.4)μg/L比(478.9±26.0)μg/L]明显高于B组,B组患者血浆D-二聚体、P-选择素、BNP明显高于A组(3.01±1.15)μg/m L比(2.15±0.28)μg/m L,(14.6±3.7)μg/L比(10.9±2.5)μg/L,(478.9±26.0)μg/L比(264.5±27.1)μg/L],差异有统计学意义(P0.05)。结论在窦性心律的心力衰竭患者中,发现BNP升高与D-二聚体,P-选择素升高成正相关。

The clinical significance of D-dimer,P-selectin and BNP detection in patients with sinus rhythm and heart failure

Objective To explore the necessity and the optimal time of anticoagulant and antithrombotic thr-erapy by detecting the level of D-dimer,P-selectin and BNP in the heart failure patients with sinus rhythm.Methods 68 patietns with heart failure and sinus rhythm were randomly divided into three groups according to the EF(Group A:who′EF value was greater than 45%,20 cases;Group B:who′EF value was greater than35% and lower than 45%, 22cases;Group C:who′EF was lower than 35%,26 cases),the concentration of D-dimer,P-selectin and BNP were measured.Results The concentration of plasma D-dimer,P-selectin and BNP in group C were significantly higher than those in group B and group A(P <0.05).Conclusion The increase level of BNP is positive related with D-di-mer and P-selectin for Sinus rhythm in patients with heart failure.