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目的:探讨血浆脑钠肽(BNP)监测对慢性心力衰竭(CHF)患者治疗的指导价值及其对预后的影响。方法:根据出院后是否进行BNP监测,将2009年5月至2010年12月我院心内科出院的CHF患者100例随机分为监测组和对照组,每组各50例。平均随访时间为1年,观察两组的治疗效果和预后包括心血管性死亡、因心血管事件再次住院例数、NYHA心功能分级、明尼苏达心衰生活质量问卷(MLHFQ)评分。结果:随访1年期间,监测组心血管性死亡率、因心血管事件再次住院率分别为2%、18.0%,对照组分别为16.0%、54.0%,差异均有统计学意义(P<0.05)。出院时与第1次随访,两组患者明尼苏达心衰生活质量问卷评分结果比较差异无统计学意义(P>0.05);而第2、3、4次随访时,监测组试验结果均显著高于对照组,差异有统计学意义(P<0.05)。随访1年时,监测组患者的NYHA心功能分级、抗心衰药物的靶剂量率显著优于对照组,差异有统计学意义(P<0.05)。结论:通过血浆BNP水平监测,及时调整治疗方案,可延缓心衰的进展,改善患者预后。
Objective: To investigate the value of plasma BNP monitoring in patients with chronic heart failure (CHF) and its effect on prognosis. Methods: According to whether BNP monitoring was performed after discharge, 100 patients with CHF discharged from our hospital from May 2009 to December 2010 were randomly divided into monitoring group and control group, with 50 patients in each group. The mean duration of follow-up was 1 year. The effects and prognosis of the two groups were observed including cardiovascular death, rehospitalization due to cardiovascular events, NYHA functional classification, and Minnesota Heart Failure Quality of Life Questionnaire (MLHFQ). Results: During the follow-up period of 1 year, the cardiovascular mortality in the monitoring group was 2% and 18.0% respectively due to cardiovascular re-entry, and the difference was statistically significant (P <0.05 for the control group, 16.0% and 54.0% respectively) ). At discharge and first follow-up, there was no significant difference in scores of Minnesota Heart Failure Quality of Life Questionnaire between the two groups (P> 0.05); while at the second, third and fourth follow-up, the test results of the monitoring group were significantly higher Control group, the difference was statistically significant (P <0.05). At 1-year follow-up, the NYHA functional class and the target dose of anti-heart failure drugs in the monitoring group were significantly better than those in the control group (P <0.05). Conclusion: The monitoring of plasma BNP levels, timely adjustment of treatment options, can delay the progress of heart failure, improve patient prognosis.