中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
20期
3050-3052
,共3页
张春德%刘家威%陈斌%张爱萍
張春德%劉傢威%陳斌%張愛萍
장춘덕%류가위%진빈%장애평
心力衰竭,充血性%心脏功能试验%利钠肽,脑
心力衰竭,充血性%心髒功能試驗%利鈉肽,腦
심력쇠갈,충혈성%심장공능시험%리납태,뇌
Heart failure,congestive%Heart function tests%Natriuretic peptide,brain
目的 探讨血浆氨基末端B型利钠肽原(NT-proBNP)评估慢性心力衰竭患者住院期间心血管不良事件的临床价值.方法 选择120例符合诊断的单纯性慢性心力衰竭患者,入院时测定血浆NT-proBNP的水平,将患者分为≤中位数血浆NT-proBNP浓度组(A组)和＞中位数血浆NT-proBNP浓度组(B组),观察两组住院期间发生室性心律失常及心脏性猝死情况.结果 B组患者左室舒张末内径明显大于A组患者[(58.80±6.90)mm比(54.32±8.00) mm,P=0.035],而B组患者的左室射血分数则明显低于A组患者[(29.16±8.31)％比(33.80±6.90)％,P=0.037]；B组患者心血管不良事件发生率(11.63％)明显高于A组(1.67％)(P＜0.05).经多变量(心脏左室舒张末内径、左室射血分数、血钾水平及血浆NT-proBNP水平)Logistic回归分析显示NT-proBNP水平与心力衰竭患者发生心血管不良事件的独立相关(OR=5.28,95％可信区间3.54～9.26,P＜0.05).结论 慢性心力衰竭患者血浆NT-proBNP水平可预测其住院期间心血管不良事件发生率,对评估慢性心力衰竭患者临床预后及指导治疗具有重要临床价值.
目的 探討血漿氨基末耑B型利鈉肽原(NT-proBNP)評估慢性心力衰竭患者住院期間心血管不良事件的臨床價值.方法 選擇120例符閤診斷的單純性慢性心力衰竭患者,入院時測定血漿NT-proBNP的水平,將患者分為≤中位數血漿NT-proBNP濃度組(A組)和＞中位數血漿NT-proBNP濃度組(B組),觀察兩組住院期間髮生室性心律失常及心髒性猝死情況.結果 B組患者左室舒張末內徑明顯大于A組患者[(58.80±6.90)mm比(54.32±8.00) mm,P=0.035],而B組患者的左室射血分數則明顯低于A組患者[(29.16±8.31)％比(33.80±6.90)％,P=0.037]；B組患者心血管不良事件髮生率(11.63％)明顯高于A組(1.67％)(P＜0.05).經多變量(心髒左室舒張末內徑、左室射血分數、血鉀水平及血漿NT-proBNP水平)Logistic迴歸分析顯示NT-proBNP水平與心力衰竭患者髮生心血管不良事件的獨立相關(OR=5.28,95％可信區間3.54～9.26,P＜0.05).結論 慢性心力衰竭患者血漿NT-proBNP水平可預測其住院期間心血管不良事件髮生率,對評估慢性心力衰竭患者臨床預後及指導治療具有重要臨床價值.
목적 탐토혈장안기말단B형리납태원(NT-proBNP)평고만성심력쇠갈환자주원기간심혈관불량사건적림상개치.방법 선택120례부합진단적단순성만성심력쇠갈환자,입원시측정혈장NT-proBNP적수평,장환자분위≤중위수혈장NT-proBNP농도조(A조)화＞중위수혈장NT-proBNP농도조(B조),관찰량조주원기간발생실성심률실상급심장성졸사정황.결과 B조환자좌실서장말내경명현대우A조환자[(58.80±6.90)mm비(54.32±8.00) mm,P=0.035],이B조환자적좌실사혈분수칙명현저우A조환자[(29.16±8.31)％비(33.80±6.90)％,P=0.037]；B조환자심혈관불량사건발생솔(11.63％)명현고우A조(1.67％)(P＜0.05).경다변량(심장좌실서장말내경、좌실사혈분수、혈갑수평급혈장NT-proBNP수평)Logistic회귀분석현시NT-proBNP수평여심력쇠갈환자발생심혈관불량사건적독립상관(OR=5.28,95％가신구간3.54～9.26,P＜0.05).결론 만성심력쇠갈환자혈장NT-proBNP수평가예측기주원기간심혈관불량사건발생솔,대평고만성심력쇠갈환자림상예후급지도치료구유중요림상개치.
Objective To explore the clinical value of plasma NT-proBNP in evaluation of major adverse cardiac event in chronic heart failure patients.Methods 120 chronic heart failure patients who measured plasma NT-proBNP were divided into two groups according to median plasma NT-proBNP level (A group:≤ median,B group:＞ median).The incidence of major adverse cardiac events,MACE(including malignant ventricular arrhythmia and sudden cardiac death) were observed during hospitalization.Results The left ventricular end-diastolic diameters (LVEDDs) in B group was longer than that in A group [(58.80 ± 6.90) mm vs (54.32 ± 8.00) mm,P =0.035)],and the left ventricular ejection fraction(LYEF) in B group was lower than that in A group[(29.16 ± 8.31) ％ vs (33.80 ± 6.90)％,P =0.037].The incidence rate of major adverse cardiac events in A group was higher than that in B group (11.63％ vs 1.67 ％,P ＜ 0.05).The multivariate Logistic regression analysis showed that the NT-proBNP level in chronic heart failure inpatients was independently associated with major adverse cardiac event during hospitalization(OR =5.28,95％ confidence intervals 3.54 ～9.26,P＜0.05).Conclusion In chronic heart failure patients,plasma NT-proBNP level could predict the MACE incidence during hospitalization,and have important value to evaluate the prognosis of chronic heart failure.
