摘要
目的:血浆脑钠肽水平对于充血性心力衰竭的预后评估均具有重要意义,但脑钠肽前体的敏感性和特异性更高。分析血浆脑钠肽前体水平对老年充血性心力衰竭患者长期预后的预测价值。方法:选择2003-05/2005-07在桂林医学院附属医院心内科住院的心力衰竭患者208例及本科同期收住院的急性冠状动脉综合征组患者26例,另外选择正常对照组30例,为本院的医学生,以上观察对象均自愿参加观察。分别测定各组观察对象的血浆脑钠肽前体水平,均在入院的第1天完成,患者出院后不再测定脑钠肽前体。使用惠普500型心动图检测心力衰竭组患者的心脏各腔室直径及射血指数。对所有出院的心力衰竭患者均进行电话随访,每3个月随访1次,平均随访2年,只电话询问死亡还是健在。结果:心力衰竭患者208例、急性冠状动脉综合征患者26例及正常对照组30例全部进入结果分析,无脱落。①各组观察对象的血浆脑钠肽前体水平比较:心力衰竭组是正常对照组的150倍[(4.82±0.75)μg/L,(31.38±29.28)ng/L(P<0.01)],是急性冠脉综合征组的23倍[(208.80±120.13)ng/L(P<0.01)]。②不同年龄、性别、病种、心功能分级心力衰竭患者血浆脑钠肽前体水平比较:心力衰竭患者脑钠肽前体的水平随年龄的增加而升高(P<0.05～0.01);女性显著高于男性(P<0.01);心功能不同级别间脑钠肽前体的水平呈倍数增加(P<0.01),死亡者显著高于生存者(P<0.01)。③心力衰竭患者血浆脑钠肽前体水平与各临床指标的相关性分析:心力衰竭患者血浆脑钠肽前体水平与年龄、左心室直径及纽约心脏协会心功能分级呈正相关(r=0.310,0.283,0.647,P<0.05～0.01),与射血指数呈负相关(r=-0.327,P<0.01)。结论:老年心力衰竭患者的血浆脑钠肽前体水平明显增高,与之相关的预后不良危险因素包括心功能分级增高、射血分数降低、左心室直径扩大、老年及女性心�
AIM： To assess the plasma N-terminal pro-B-type natriuretic peptide （pro-BNP）, which is high in sensitivity and specificity, for predicting prognosis and Ioog-term mortality in eldedy patients with congestive heart failure （CHF）.
METHODS： The level of pro-BNP was measured in baseline serum samples from 208 CHF patients, 26 patients with acute coronary syndrome （ACS） without heart failure, one day after they were hospitalized in Department of Cardiology, Affiliated Hospital of Guilin Medical College between May 2003 and July 2005. Moreover, 30 medical students were taken as normal control group. All the subjects were volunteered to join the study. The rate of death from all cases was determined after a median follow-up of mean two years, once three months. The atria diameter, ventricular end-diastolic diameter （VED） and ejection fraction （EF） were measured by HP 500 B model echocardiography.
RESUETS： All 208 CHF patients, 26 ACS patients and 30 normal controls were involved in the result analysis without any drop. （1）Comparison on the level of pro-BNP： The mean level in the CHF group was 150 folds and 23 folds higher than that of the normal control [（4.82±0.75） μg/L, （31.38±29.28） ng/L, P 〈 0.01] and ACS group [（208.80±120.13） ng/L, P 〈 0.01]. （2）The level of pro-BNP in CHF patients was increased associated with ageing （P 〈 0.05-0.01）, and much higher in female patients than in male patients （P 〈 0.01）. The values of pro-BNP were increased in fold associated with the NYHA class significantly （P 〈 0.001 ）, and much higher in the died patients than that of the survival groups （P 〈 0.001）.（3）Correlation analysis on the values of pro-BNP and clinical index： The pro-BNP level in CHF patients showed a positive correlation with NYHA class, left VED and age （r =0.310, 0.283, 0.647, P 〈 0.05-0.01）, negative correlation with EF （r =-0.327, P〈 0.01）. CONCLUSION; The level of pro-BNP is obviously increased in elderly patients
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第25期4895-4898,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
广西科技厅资助课题(0322025-10)~~
