脑钠肽在心脏外科手术中的作用  

The role of brain natriuretic peptide in cardiac surgery

作　　者：马义丽[1] 庄熙晶[1] 李冠燃[1] 何学志[1] 梁永才[1] 

机构地区：[1]大连市中心医院心外科,116033

出　　处：《中国医师进修杂志》2011年第17期24-26,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨脑钠肽（BNP）对心脏外科手术患者预后的影响。方法选择首次行心脏外科手术患者115例，进行术前BNP测定，观察BNP与术后发生心房颤动、呼吸机使用时间、住院时间及术后30d病死率等情况的关系。结果患者是否有高血压、糖尿病、心肌梗死病史，是否存在左主干病变及血红蛋白水平与BNP指标无明确的相关性（P〉0．05）。欧洲心脏手术风险评估系统评分[（5±3）分]，与BNP水平明显相关（P=0．003），BNP与左室射血分数有相关性（P=0．002）。术后呼吸机使用时间（15．0±5．4）h，住院时间（32±11）d，与BNP有明确的相关性（P=0．035、0．001），但与术后纵隔感染、心房颤动及术后30d病死率之间的关系不确切（P〉0．05）。结论BNP可以用于心脏外科手术后风险的预测。Objective To investigate the influence of brain natriuretic peptide （BNP） in the prognosis of cardiac surgery. Methods Selected 115 cases of patients with the first cardiac surgery. Their BNP concentration was measured before operation. Observed the relationship between BNP and postoperative atrial fibrillation, mechanical ventilation time, hospital stay, and the mortality of 30 d. Results Whether the patients had hypertension, diabetes, myocardial infarction history, left main stem disease and hemoglobin level or not, showed no definite relationship with BNP （P 〉 0.05）. Preoperative lower left ventricular ejection fraction （LVEF） （P = 0.002） and European system for cardiac operation risk evaluation [ （5 ±3 ） scores] （P = 0.003 ） were associated with higher BNP level. Postoperative mechanical ventilation time was （15.0 ±5.4） h, hospital stay was （32± 11） d, showed a clear relationship with BNP （P= 0.035,0.001 ）, but postoperative mediastinal infection, atrial fibrillation and mortality of 30 d had no definite relationship with BNP （P 〉 0.05 ）. Conclusion BNP can be used to predict the risk after cardiac surgery.

关 键 词：利钠肽 脑 心脏外科手术 

分 类 号：R654.2[医药卫生—外科学]