BMI和BNP水平与慢性心力衰竭预后的相关性

目的 本研究旨在探讨体重指数BMI和BNP水平在左心室收缩功能正常的心力衰竭（以下简称心衰）患者中的相关性以及与此类患者预后的关系.方法 回顾性分析100例左心室收缩功能正常的心衰患者,根据其BMI将其分为3组,即正常体重组（BMI＜ 25kg/m2）、超重组（25kg,/m2≤BMI＜ 30kg/m2）、肥胖组（BMI≥30kg/m2）,统计3组的BNP水平,进一步随访患者的全因病死率及再入院率.结果 肥胖组患者BNP水平最低中位数260pg/ml（115 ～ 569pg/ml）],超重组BNP水平次之中位数428pg/ml（249～ 875pg/ml）],正常体重组BNP水平最高中位数697pg/ml （354 ～ 1286pg/ml）];而肥胖组与超重组全因病死率及再入院率明显低于正常体重组,分别为45％、40％、64％ （P =0.002）.结论 在左心室收缩功能正常的心衰患者中BMI与BNP水平呈负相关,而患者BNP水平越高其预后较差.

Correlation between BMI,BNP Levels and Prognosis in Heart Failure Patients

Objective To investigate the relationship between the body mass index （BMI） and BNP levels in heart failure patients with preserved left ventricular systolic function as well as the correlation between the prognosis in these patients.Methods Retrospective analysis of 315 cases of heart failure patients with preserved left ventricular systolic function was performed.They were divided into three groups according to their BMI,namely,normal weight （BMI ＜ 25kg/m2）,overweight （25kg/m2 ≥ BMI ＜ 30kg/m2） and obese （BMI≥ 30kg/m2）.Then their BNP levels were counted.They all-cause mortality and heart failure hospitalization rate were followed up.Results BNP levels were the lowest in obese group （median 260pg/ml）,followed by overweight （median 428pg/ml） group.Normal weight group was in highest BNP levels （median 697pg/ml）.The all-cause mortality was significantly lower in obese group and overweight group than the normal weight group.Conclusion The BMI and BNP levels are inversely related in heart failure patients with preserved left ventricular systolic function.Higher BMI is associated with good prognosis,whereas higher BNP levels predict bad prognosis in heart failure patients with preserved left ventricular systolic function.