摘要
目的探究联合脑钠肽及心力衰竭超声指数诊断早期慢性心力衰竭的价值。方法选择146例慢性心力衰竭患者及75例心功能正常的健康人。根据NYHA分级,将慢性心力衰竭患者分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级,其中Ⅰ级26例,Ⅱ级43例,Ⅲ级48例,Ⅳ级29例。结果对比慢性心力衰竭患者和心功能正常的健康人的一般资料,包括年龄、性别、ALT、AST、空腹血糖、总胆固醇、甘油三酯、血肌酐和CRP,发现差异均无统计学意义(P>0.05);将两组的BNP进行比较,发现Ⅱ(181.19±48.06)、Ⅲ(279.26±49.45)和Ⅳ级(882.34±388.71)慢性心力衰竭患者BNP显著高于健康人(54.12±25.87),而且随着患者心力衰竭程度加重,BNP逐渐升高,差异均有统计学意义(P<0.05),而Ⅰ级患者(77.14±24.32)与健康人相比,差异无统计学意义(P>0.05);比较两组的HFEI,发现慢性心力衰竭患者HFEI显著高于健康人(0.78±0.42),而且对比Ⅰ(1.58±0.89)、Ⅱ(2.64±1.07)、Ⅲ(4.47±1.39)和Ⅳ级(6.33±1.61)患者HFEI,发现随着患者心力衰竭程度加重,HFEI逐渐升高,差异均有统计学意义(P<0.05);对BNP和HFEI进行相关性分析,发现慢性心力衰竭患者BNP和HFEI呈显著正相关(r=0.935,P=0.000);采用ROC曲线分析,血浆BNP联合HFEI诊断早期慢性心力衰竭ROC曲线下面积为0.970,结果表明血浆BNP联合HFEI对慢性心力衰竭的诊断准确率高。结论血浆脑钠肽及心力衰竭超声指数对慢性心力衰竭早期有诊断意义。
Objective To investigate the value of brain natriuretic peptide and heart failure ultrasound in the diagnosis of early chro- nic heart failure. Methods One hundred and forty - six patients with chronic heart failure and seventy - five heahhy people with normal heart function were involved. According to NYHA classification, patients with chronic heart failure were divided into grade Ⅰ、Ⅱ、Ⅲ and Ⅳ, including grade Ⅰ twenty six, grade Ⅱ forty three, grade Ⅲ forty eight and grade Ⅲ twenty nine patients. Results There was no significant difference in the general information between patients with chronic heart failure and healthy people with normal heart function （P 〉 0. 05）, including age, sex, ALT, AST, fasting blood glucose, total cholesterol, triglyceride, serum creatinine and CRP. The BNP of the two groups were compared, and we found the BNP of grade Ⅱ（181.19 ±48.06）, Ⅲ （279.26 ±49.45） and Ⅳ（882.34 ± 388.71 ） patients was significantly higher than healthy people （54.12 ±25.87 ） , and with the severity of heart failure, BNP increased gradually. There was statistically significant the difference （ P 〈 0.05 ）. but there was no significant difference between the patients of grade I （77.14 ± 24.32 ） and healthy people （P 〉 0.05 ）. Compared with healthy people （0.78 ± 0.42） , HFEI was significantly higher in patients with chronic heart failure. The HFEI of grade Ⅰ（1.58±0.89）,Ⅱ （2.64 ±1.07）, Ⅲ（4.47 ±1.39） and Ⅳ（6.33 ± 1.61 ） were compared, we found HFEI increased gradually with the severity of heart failure, and the difference was statistically significant （P 〈 0.05 ）. From the analysis between BNP and HFEI, we found that BNP was significantly positively correlated with HFEI in patients with chronic heart failure （r = 0. 935, P = 0. 000）. From ROC curve analysis, the area under the ROC curve of early chronic heart failure was 0. 970, showing that plasma BNP combined with HFEI could be accurately diagnosed early c
出处
《医学研究杂志》
2017年第10期63-67,157,共6页
Journal of Medical Research
基金
首都卫生发展科研专项基金资助项目(2016-1-2194)
关键词
血浆脑钠肽
心力衰竭超声指数
慢性心力衰竭
Plasma brain natriuretic peptide
Heart failure echocardiography index
Chronic heart failure
