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目的:探讨血浆B型钠尿肽(BNP)水平在慢性充血性心力衰竭诊断中的临床价值。方法:按照NYHA心功能分级标准,入选NYHAⅡ、Ⅲ、Ⅳ级心内科住院患者151例,采用快速免疫荧光法测定血浆中BNP水平,心脏彩色多普勒超声诊断仪测量左室结构和功能,并分析BNP水平与经心脏超声测量心脏结构指标间相关性。结果:冠心病、风心病和心肌病患者血浆中BNP水平差异不显著(P>0.05)。心功能Ⅳ、Ⅲ级患者血浆中BNP水平显著高于Ⅱ级(P<0.05),Ⅳ级BNP水平显著高于Ⅲ级(P<0.05)。相关分析结果显示,血浆BNP水平与LVEDD呈正相关(r=0.39,P<0.05);与LVEF呈负相关(r=-0.38,P<0.05)。结论:血浆BNP水平与心功能分级、心脏结构显著相关,是慢性充血性心力衰竭诊断的敏感指标。
Objective: To investigate the clinical value of plasma BNP level in the diagnosis of chronic congestive heart failure. Methods: According to NYHA functional classification criteria, 151 inpatients with NYHA Ⅱ, Ⅲ, Ⅳ cardiology were enrolled. Plasma BNP levels were measured by rapid immunofluorescence. Left ventricular structure and function were measured by color Doppler ultrasonography The correlation between BNP level and cardiac structure measured by echocardiography was analyzed. Results: Plasma BNP levels in patients with coronary heart disease, rheumatic heart disease and cardiomyopathy were not significantly different (P> 0.05). Plasma BNP levels in patients with grade IV and III cardiac function were significantly higher than those in grade II (P <0.05), and grade IV BNP levels were significantly higher than those in grade III (P <0.05). Correlation analysis showed that plasma BNP level was positively correlated with LVEDD (r = 0.39, P <0.05), negatively correlated with LVEF (r = -0.38, P <0.05). Conclusion: Plasma BNP level is significantly correlated with cardiac function classification and cardiac structure, which is a sensitive index for the diagnosis of chronic congestive heart failure.