老年慢性心力衰竭患者血浆脑钠肽水平观察

目的 研究血浆脑钠肽(BNP)在老年慢性心力衰竭(CHF)患者的诊断、治疗和预后评估中的临床作用. 方法 选取2010年1月至2011年3月我科住院206例＞60岁老年CHF患者,按照纽约心脏病学会(NYHA)心功能分级分为4组,采用ELISA法测定患者血液BNP的水平,并测定左心室射血分数(LVEF).在抗心力衰竭治疗2周后或出院时复测上述指标,进行统计学分析. 结果 按NYHA心功能分级的各组患者血浆BNP的水平差异具有统计学意义,心功能越严重,年龄越大,BNP值越高,而LVEF差异仅在Ⅰ、Ⅲ、Ⅳ级心功能间有意义(P＜0.05)；经抗心衰治疗后,患者心衰症状缓解,复测BNP值下降而LVEF升高,但仅BNP的变化有统计学意义. 结论 BNP值可作为较可靠的老年CHF的早期预测参考指标,也可作为判断心功能不全严重程度和疗效以及预测预后的指标,而且操作简便,易于重复.

Study on changes of B-type natriuretic peptide in the elderly with chronic heart failure

Objective To study the clinical effect of B-type natriuretic peptide(BNP) on clinical diagnosis,treatment and prognosis assessment in the elderly with chronic heart failure(CHF).Methods 206 cases were selected from CHF patients aged>60 in hospital during January 2010 to March 2011.All cases were divided into four groups according to the cardiac grading of New York heart association(NYHA).The levels of BNP were determined by ELISA and left ventricular ejection fraction(LVEF) was measured by echocardiography before and after two weeks’ treatment.After treatment of resistance to heart failure or when leaving hospital,statistical analysis was carried out.Results According to NYHA cardiac grading,plasma BNP levels were statistically different among four groups.Higher BNP value was accompanied with more serious cardiac function and older ages.Significant differences of LVEF were observed only inⅠ,ⅢandⅣcardiac function(P<0.05).After treatment,the symptoms of heart failure were mitigated in CHF patients.The levels of BNP declined while LVEF went up,only changes of BNP showed statistical significance.Conclusions BNP value can be used as a reliable reference index in the earlier prognosis for the elderly CHF,and also as indexes in assessing severity of cardiac insufficiency and efficacy of treatment,and in predicting the prognosis.In addition,it is easy to operate and repeat.