摘要
目的探究分析老年慢性心衰患者抗心衰治疗后血浆脑利钠肽(BNP)水平分布及影响因素。方法方便选取该院2017年1月-2018年12月收治的老年慢性心衰患者110例,全部患者接受抗心衰治疗,对患者资料进行回顾性分析,按照出院时脑利钠肽(BNP)水平进行分组,分对照组(41例,BNP>463 pg/mL)、试验组(69例,BNP≤463 pg/mL),分析比较影响BNP水平的因素。结果出院时41例BNP水平未恢复正常,占比37.27%,试验组与对照组比较,舒张压(78.29±3.85)mmHg vs (65.53±3.45) mmHg(t=17.457,P=0.000),收缩压(139.29±3.35)mmHg vs (123.46±5.11) mmHg(t=19.623,P=0.000),心率(75.29±2.41)次/min vs (87.29±2.35)次/min(t=25.484,P=0.000),肺动脉高压(30.08±2.35)mmHg vs (36.11±2.41) mmHg(t=12.990,P=0.000);对照组与试验组其他指标比较,肺淤血发生率65.85%vs 5.80%(χ~2=45.831,P=0.000)、房颤60.98%vs 14.49%(χ~2=25.614,P=0.000)、冠心病发生率68.29%vs 15.94%(χ~2=430.800,P=0.000)均高于试验组;多因素分析结果显示老年慢性心衰患者抗心衰治疗后BNP水平较高独立危险因素包括冠心病(R^2=0.172,F=13.241,β=-0.412,P=0.012)、舒张压(R^2=0.097,F=6.214,β=-3.124,P=0.042)、收缩压(R^2=0.278,F=23.417,β=-0.562,P=0.000)、肺淤血(R^2=0.319,F=29.872,β=0.579,P=0.000)、肺动脉高压(R^2=0.089,F=6.210,β=0.302,P=0.017),均差异有统计学意义(P<0.05)。结论老年慢性心力衰竭患者出院时存在BNP水平较高情况,通过多因素分析可知危险因素为房颤、低血压、淤血等,临床上应确定高危患者,密切监测患者情况,做对症处理,并强化随访工作。
Objective To explore and analyze the distribution of plasma brain natriuretic peptide(BNP) level and its influencing factors in elderly patients with chronic heart failure after anti-heart failure treatment. Methods Convenient selection 110 elderly patients with chronic heart failure in the hospital were selected. From January 2017 to December2018, all patients received anti-heart failure treatment. The data of patients were analyzed retrospectively. According to the level of brain natriuretic peptide(BNP) at discharge, the patients were divided into control group(41 cases, BNP>463 pg/mL) and experimental group(69 cases, BNP ≤463 pg/mL). The factors affecting BNP level were analyzed and compared.Results At the time of discharge, the level of BNP in 41 cases did not return to normal, accounting for 37.27%. The difference between the control group and the experimental group was statistically significant, with diastolic blood pressure(78.29 ±3.85) mmHg vs(65.53 ±3.45)mmHg(t =17.457, P =0.000) and systolic blood pressure(139.29 ±3.35) mmHg vs(123.46±5.11) mmHg(t=19.623, P=0.000), heart rate(75.29±2.41) times/min vs(87.29±2.35) times/min(t=25.484, P=0.000),pulmonary artery pressure(30.08±2.35)mmHg vs(36.11±2.41)mmHg(t=12.990, P=0.000). There were significant differences between the control group and the test group in other indicators: the incidence of pulmonary congestion 65.85% vs 5.80%(χ~2=45.831, P=0.000), atrial fibrillation 60.98% vs 14.49%(χ~2=25.614, P=0.000), and the incidence of coronary heart disease 68.29% vs 15.94%(χ~2=430.800, P=0.000) were all higher than the test group. The results of multivariate analysis showed that the elderly patients with chronic heart failure had higher BNP levels after anti-heart failure treatment, independent risk factors included coronary heart disease(R^2=0.172, F=13.241, β=-0.412, P=0.012), diastolic blood pressure(R^2=0.097, F=6.214, β=-3.124, P=0.042), systolic blood pressure(R^2=0.278, F=23.417, β=-0.562, P=0.000), pulmonary congestion(R^2=0.319, F =29.872,
作者
刘丽丽
LIU Li-li(Department of Circulation,Huadian People's Hospital,Huadian,Jilin Province,132400 China)
出处
《中外医疗》
2020年第5期13-16,共4页
China & Foreign Medical Treatment
关键词
慢性心力衰竭
老年患者
BNP
肺淤血
房颤
Chronic heart failure
Elderly patients
BNP
Pulmonary congestion
Atrial fibrillation
