血浆BNP水平在慢性心衰的诊断、病情及预后评估中的应用

目的 探讨血浆BNP水平检测对慢性心衰诊断、病情及预后评估的临床价值.方法 随机选取2013年1月至2015年4月本院心内科收治的慢性心衰患者90例,患者NYHA分级结果在Ⅱ～Ⅳ级之间,对所有患者的血浆BNP水平进行检测,同时对其左室舒张末期内径、左室射血分数、血脂水平等指标进行检测记录,根据心功能分级及血浆BNP水平对其临床资料进行回顾性分析.结果 不同心功能分级组患者相比血浆BNP水平、LVEF、LVEDD存在统计学差异(P＜0.05);观察A组患者的低密度脂蛋白(3.05±0.97)mmol/L]、高密度脂蛋白(1.39±0.47)mmol/L]、胆固醇(4.53±1.12)mmol/L]水平均明显高于观察B组(2.57±0.93)mmol/L,(1.11±0.43)mmol/L,(3.89±1.28)mmol/L],差异有统计学意义(P＜0.05).结论 血浆BNP水平能够有效反映机体左室功能的变化,可作为心功能受损的敏感指标,同左心室重塑和心功能状态之间存在密切相关性.通过对慢性心力衰竭患者的血浆BNP水平进行检查,可为临床诊断、治疗和预后评估提供可靠的依据.

The application of plasma BNP level in the diagnosis,the severity and prognosis evaluation of chronic heart failure

Objective To investigate the clinical value of the detection of plasma BNP level in the diagnosis,the severity and prognosis evaluation of chronic heart failure.Methods 90 cases of chronic heart failure admitted in our hospital from January 2013 to April 2015 were randomly selected,whose NYHA grading results ranged from Ⅱ to Ⅳ.All patients' plasma BNP level was detected.Left ventricular enddiastolic diameter (LVEDD),left ventricular ejection fraction (LVEF) and blood lipid level were detected and recorded.The clinical data was retrospectively analyzed according to cardiac functional grading and plasma BNP level.Results There were statistically significant differences in plasma BNP levels,LVEF and LVEDD among different cardiac functional grading patients (P＜0.05).The levels of low-density lipoprotein,high-density lipoprotein and cholesterol in observation group A were significantly higher than those in observation group B (3.05±0.97)mmol/L vs.(2.57±0.93)mmol/L;(1.39±0.47)mmol/L vs.(1.11 ±0.43)mmol/L;(4.53± 1.12)mmol/ L vs.(3.89±l.28)mmol/L],with statistically significant differences (P＜0.05).Conclusions Plasma BNP level can effectively reflect the changes of left ventricular function,and be used as a sensitive index of the damage of cardiac function,and is closely related with left ventricular remodeling and cardiac function.By detecting the level of plasma BNP in patients with chronic heart failure,reliable basis can be provided for the clinical diagnosis,treatment of the disease,and the prognosis evaluation.