摘要
目的探讨血浆N末端脑钠肽前体(NT-proBNP)为目标导向治疗慢性心力衰竭(CHF)患者近期预后和对患者心功能的影响。方法选取2017年2月至2019年2月于西安交通大学医学院第一附属医院收治的CHF患者96例,随机分为对照组和观察组各48例,对照组根据患者症状和体征用药,观察组则根据动态监测NT-pro BNP水平指导用药。对比两组患者的临床疗效、治疗前和治疗3个月后的心功能[左室射血功能(LVEF)、左室收缩末期内径(LVESD)、心排血量(CO)、心脏每搏输出量(SV)、6 min步行距离(6MWD)、心脏指数(CI)]、血浆NT-proBNP水平,记录患者出院后3个月内再入院率和病死率。结果观察组患者治疗总有效率较对照组显著提高(87.50%vs. 75.00%,P<0.05)。治疗3个月后,观察组患者的LVEF、CO、SV、6MWS和CI水平均较对照组显著提高(P<0.05),LVESD水平较对照组显著降低(P<0.05)。治疗3个月后,两组患者血浆NT-pro BNP水平均较治疗前降低,且观察组显著低于对照组(P<0.05)。观察组患者出院后3个月内再入院率和病死率均显著低于对照组[(8.33%vs. 18.75%)、(0 vs. 6.25%),P<0.05]。结论对CHF患者的血浆NT-proBNP水平进行动态监测,并根据监测结果指导用药,可显著提高近期疗效,改善患者心功能,降低血浆NT-pro BNP水平,减少再入院率和病死率。
Objective To investigate the influence of plasma N-terminal pro-brain natriuretic peptide(NTpro BNP) target-directed treatment on short-term prognosis and heart function in patients with chronic heart failure(CHF). Methods CHF patients(n=96) were chosen from the First Affiliated Hospital of Medical School of Xi’an Jiaotong University from Feb. 2017 to Feb. 2019, and divided randomly into control group and observation group(each n=48). The control group was given medication treatment according to patients’ symptoms and signs, and observation group was given medication treatment according to dynamic monitoring of NT-proBNP level. The clinical efficacy, heart function indexes [left ventricular ejection fraction(LVEF), left ventricular end-systolic diameter(LVESd), cardiac output(CO), stroke volume(SV), 6-minute walk distance(6 MWD) and cardiac index(CI)] and level of plasma NTpro BNP were compared between 2 groups. The re-hospitalization rate and mortality within 3 months after discharging were recorded in 2 groups. Results The total effective rate was significantly increased in observation group compared with control group(87.50% vs. 75.00%, P<0.05). After treatment for 3 months, the levels of LVEF, CO, SV, 6 MWS and CI increased significantly(P<0.05) and LVESd level decreased significantly(P<0.05) in observation group compared with control group. After treatment for 3 months, the level of plasma NT-proBNP decreased, and was significantly lower in observation group than that in control group(P<0.05). The re-hospitalization rate(8.33% vs. 18.75%) and mortality(0 vs. 6.25%) within 3 months after discharging were significantly lower in observation group than those in control group(P<0.05). Conclusion The dynamic monitoring of plasma NT-proBNP level and treatment according to monitoring results can significantly promote short-term curative effect, improve heart function, reduce plasma NTpro BNP level and decrease re-hospitalization rate and mortality in CHF patients.
作者
李萍
李汶嘉
王小芹
Li Ping;Li Wenjia;Wang Xiaoqin(Department of Neurology,First Affiliated Hospital of Medical School of Xi'an Jiaotong University,Xi'an 710061,China)
出处
《中国循证心血管医学杂志》
2019年第10期1241-1243,1247,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
慢性心力衰竭
近期预后
血浆N末端脑钠肽前体
心功能
Chronic heart failure
Short-term prognosis
Plasma N-terminal pro-brain natriuretic peptide
Heart function
