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目的探讨血浆D-二聚体和N末端B型利钠肽原(NT-pro BNP)水平对超高龄心力衰竭患者心功能及预后的评估价值。方法选取2012年6月—2014年2月海南省中医院收治的超高龄心力衰竭患者84例,按照纽约心脏病协会(NYHA)标准心功能分级:Ⅰ级18例,Ⅱ级15例,Ⅲ级24例,Ⅳ级27例;随访1年,记录心源性死亡情况。比较不同心功能分级、预后患者一般资料及血浆D-二聚体、NT-pro BNP水平。结果不同心功能分级患者性别、年龄、原发疾病比较,差异均无统计学意义(P>0.05);心功能Ⅱ、Ⅲ、Ⅳ级患者血浆D-二聚体、NT-pro BNP水平高于心功能Ⅰ级患者,心功能Ⅲ、Ⅳ级患者血浆D-二聚体、NT-pro BNP水平高于心功能Ⅱ级患者,心功能Ⅳ级患者血浆D-二聚体、NT-pro BNP水平高于心功能Ⅲ级患者(P<0.05)。不同预后患者性别、年龄、原发疾病比较,差异无统计学意义(P>0.05);死亡患者血浆D-二聚体、NT-pro BNP水平高于存活患者。结论血浆D-二聚体和NT-pro BNP可作为评估超高龄患者心力衰竭严重程度及预后的指标。
Objective To evaluate the value of plasma D-dimer and N-terminal pro-brain natriuretic peptide (NT-pro BNP) levels in patients with over-age heart failure. Methods Totally 84 elderly patients with heart failure admitted to Hainan Provincial Hospital of Traditional Chinese Medicine from June 2012 to February 2014 were enrolled in this study. According to the New York Heart Association (NYHA) criteria, 18 were grade Ⅰ, 15 were grade Ⅱ, 24 cases, grade Ⅳ 27 cases; followed up for 1 year, record cardiac death. Comparison of different cardiac function classification, prognosis of patients with general information and plasma D-dimer, NT-pro BNP levels. Results There were no significant differences in sex, age and primary disease among patients with different cardiac function scores (P> 0.05). The plasma levels of D-dimer and NT-pro BNP in patients with grades Ⅱ, Ⅲ and Ⅳ of cardiac function were higher Plasma level of D-dimer and NT-pro BNP were significantly higher in patients with grade I heart function than those with grade III or IV heart disease, and plasma levels of D-dimer and NT-pro BNP in patients with grade IV heart function Higher than those with grade Ⅲ heart function (P <0.05). There was no significant difference in gender, age and primary disease among different prognosis patients (P> 0.05). The plasma levels of D-dimer and NT-pro BNP in patients with death were higher than those in survivors. Conclusions Plasma D-dimer and NT-pro BNP can be used as indicators for assessing the severity and prognosis of heart failure in over-aged patients.