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目的探讨血浆B型脑钠肽(BNP)在慢性肺源性心脏病中的应用价值。方法测定98例慢性肺源性心脏病心功能失代偿期和50例慢性肺源性心脏病心功能代偿期患者治疗前BNP水平并进行比较。结果心功能失代偿右心功能不全组BNP为(296.1±96.8)pg/ml,左心功能不全组BNP为(520.7±172.6)pg/ml,两组间比较差异有统计学意义(P<0.05),两组与心功能代偿组相比,差异也均有统计学意义(P<0.05);右心功能不全组BNP与肺动脉压力呈正相关,与PaO2呈负相关;左心功能不全组BNP与左室内径呈正相关,与左室射血分数呈负相关。单变量和Cox模型多变量回归分析显示,入院时BNP的浓度检测可以作为心脏事件发生的独立预测指标。入院时BNP≥219.7pg/ml的患者,因心脏事件死亡和再次住院率提高。结论血浆BNP水平在肺源性心脏病有重要的应用价值。
Objective To investigate the clinical value of plasma brain natriuretic peptide (BNP) in chronic cor pulmonale. Methods The levels of BNP in 98 patients with decompensated chronic cor pulmonale and 50 patients with decompensated chronic cor pulmonale were measured and compared. Results BNP was (296.1 ± 96.8) pg / ml in patients with decompensated right ventricular dysfunction, and (520.7 ± 172.6) pg / ml in patients with left ventricular dysfunction. There was significant difference between the two groups (P < 0.05). There was also a significant difference between the two groups (P <0.05) and the compensatory group (P <0.05). BNP was positively correlated with pulmonary arterial pressure and negatively correlated with PaO2 in patients with right ventricular dysfunction BNP and left ventricular diameter was positively correlated with left ventricular ejection fraction was negatively correlated. Multivariate regression analysis of univariate and Cox models showed that BNP concentration at admission was an independent predictor of cardiac events. Patients on BNP ≥ 219.7 pg / ml on admission had died of cardiac events and had an increased rate of hospitalization again. Conclusion Plasma BNP levels have important clinical value in patients with pulmonary heart disease.