心力衰竭患者发生心血管事件的危险因素及脑钠肽的早期诊断价值  

Risk factors of cardiovascular events in patients with heart failure and the value of brain natriuretic peptide in the early diagnosis of cardiovascular disease

作　　者：陈小龙[1] 杜婷婷[1] 魏延虎 

机构地区：[1]陕西省延安市人民医院检验科,716000

出　　处：《检验医学与临床》2017年第3期364-366,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨心力衰竭患者发生心血管事件的危险因素及脑钠肽(BNP)的早期诊断价值。方法选取2014年1月至2016年1月该院收治的心力衰竭患者110例作为心力衰竭组,再选取于该院体检的健康志愿者40例作为对照组,比较2组研究对象的血浆BNP、C反应蛋白(CRP)水平;左室射血分数(LVEF)、6min步行距离、左室舒张末期容积、左房舒张末期容积及心功能分级等。结果与对照组比较,心力衰竭组患者BNP、CRP水平较高,LVEF较低,6min步行距离较短,左室舒张末期容积、左房舒张末期容积较大,差异均有统计学意义(P<0.05)。与心功能Ⅰ级比较,心功能Ⅱ级患者BNP水平较高,差异均有统计学意义(P<0.05),CRP、LVEF、6min步行距离、左室舒张末期容积、左房舒张末期容积在心功能Ⅰ级和Ⅱ级间比较,差异无统计学意义(P>0.05)。Logistic回归分析发现,BNP≥1 735pg/mL(OR=7.078,95%CI=1.232~37.554)、CRP≥10 mg/mL(OR=4.884,95%CI=1.472~16.208)、LVEF≤35%(OR=5.709,95%CI=1.758~18.541)的心力衰竭患者发生心血管事件的危险因素(P<0.05)。结论血浆BNP检测有利于早期诊断心力衰竭,血浆BNP、CRP及LVEF是心力衰竭患者发生心血管事件的危险因素。Objective To investigate the risk factors of cardiovascular events in patients with heart failure and the value of brain natriuretic peptide in the early diagnosis of cardiovascular disease.Methods A total of 110 patients with heart failure in our hospital from January 2014 to January 2016 were selected as the heart failure group and 40 healthy volunteers were selected as the control group.Plasma brain natriuretic peptide（BNP）,C-reactive protein（CRP）,left ventricular ejection fraction（LVEF）,6 minutes walking distance,left ventricular end diastolic volume,left atrial end diastolic volume and cardiac function classification of objects in two groups were compared.Results Compared with objects in control group,patients in heart failure group had higher level of BNP,CRP and lower LVEF and shorter 6minute walk distance and bigger left ventricular end diastolic volume,left atrial end diastolic volume（P〈0.05）.Compared with patients with heart function Ⅰ,patients with heart function Ⅱ had higher level of BNP（P〈0.05）.There were no significant differences between heart function Ⅰ and heart functionⅡ of CRP,LVEF,6minutes walking distance,left ventricular end diastolic volume,left atrial end diastolic volume（P〈0.05）.Logistic regression analysis showed that BNP≥1 735pg/mL（OR=7.078,95%CI=1.232-37.554）,CRP≥10mg/mL（OR=4.884,95%CI=1.472-16.208）,LVEF≤35%（OR=5.709,95%CI=1.758-18.541）were risk factors for cardiovascular events in patients with heart failure（P〈0.05）.Conclusion Plasma BNP detection is beneficial to early diagnosis of heart failure,plasma BNP,CRP and LVEF are the risk factors of cardiovascular events in patients with heart failure.

关 键 词：脑钠肽 心力衰竭 早期诊断 预后 

分 类 号：R541[医药卫生—心血管疾病]