老年慢性心力衰竭患者BNP、Hcy、血脂水平变化与心功能及预后的关系  

Relationship among BNP,Hcy,changes of blood lipid level,heart function and prognosis in elderly patients with chronic heart failure

作　　者：李婷婷 吕留强[1] 赵立[1] Li Tingting;Lyu Liuqiang;Zhao Li(Department of Cardiology,People's Hospital of Huaibei City,Huaibei 235000,China)

机构地区：[1]淮北市人民医院心内科,淮北235000

出　　处：《中国循证心血管医学杂志》2021年第9期1050-1053,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：安徽省自然科学基金项目课题(1808085MH157)。

摘　　要：目的观察老年慢性心力衰竭患者脑钠肽(BNP)、同型半胱氨酸(Hcy)、血脂水平变化与心功能的关系,并分析与患者预后和死亡的关系。方法将淮北市人民医院心内科于2017年1月至2019年8月间收治的老年慢性心力衰竭患者70例为观察组,另选择30例同期心功能正常且无其他相关合并症的住院患者为对照组。收集所有患者的BNP、Hcy、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平变化及死亡资料。比较BNP、Hcy、血脂水平在患者与健康者、不同心功能及死亡与存活患者间的变化。采用Logistic回归分析分析患者死亡危险因素。结果观察组BNP、Hcy明显高于对照组,TG、TC、HDL-C明显低于对照组(P均<0.05)。不同NYHA心功能分级患者BNP、Hcy、TG、TC、HDL-C差异均有统计学意义(P均<0.05),随着患者心力衰竭(心衰)病情的加重,BNP、Hcy逐渐增加,TG、TC、HDL-C逐渐降低。经过治疗后心衰患者BNP、Hcy、TG、TC、HDL-C均逐渐趋于正常,与入院时比较差异均有统计学意义(P均<0.05)。在住院和随访期间死亡31例,均为心源性死亡,存活39例,与存活患者比较,死亡患者BNP、Hcy明显升高(P均<0.05),以死亡作为因变量,将BNP、Hcy两个指标分别作为自变量进行Logistic回归分析,结果发现BNP、Hcy均是心衰患者死亡的独立危险因素。结论老年心衰患者通过检测BNP和Hcy水平可评估预后和死亡风险,同时结合血脂水平来综合判断患者病情,为临床治疗和康复提供依据。Objective To observe the relationship among B-type natriuretic peptide(BNP),homocysteine(Hcy),changes of blood lipid level and heart function,and analyze the relationship between prognosis and death in elderly patients with chronic heart failure(CHF).Methods the elderly patients with CHF(n=70)were chosen into observation group and in-hospital patients(n=30)with normal heart function and without other complications were chosen into control group from Department of Cardiology in People’s Hospital of Huaibei City from Jan.2017 to Aug.2019.The changes of BNP,Hcy,triglyceride(TG),total cholesterol(TC),high-density lipoprotein-cholesterol(HDL-C)and low-density lipoprotein-cholesterol(LDL-C)and death materials were collected in 2 groups.The changes of BNP,Hcy and blood fat level were compared between 2 groups and between died patients and survival patients.The risk factors of death were analyzed by using Logistic regression analysis.Results The levels of BNP and Hcy were significantly higher,and levels of TG,TC and HDL-C were significantly lower in observation group than those in control group(all P<0.05).The difference in levels of BNP,Hcy,TG,TC and HDL-C had statistical significance in patients with different NYHA classes(all P<0.05),and as exacerbation of CHF,levels of BNP and Hcy increased gradually and levels of TG,TC and HDL-C decreased gradually.After treatment,levels of BNP,Hcy,TG,TC and HDL-C tended to normal levels gradually compared with those at admission time(all P<0.05).There were 31 patients died(cardiac death)and 39 survived during hospitalization and follow-up periods.The levels of BNP and Hcy increased significantly in survival patients compared with those in died patients(all P<0.05).The results of Logistic regression analysis showed that,taken death as dependent variable and BNP and Hcy as independent variables,BNP and Hcy were independent risk factors of death in CHF patients.Conclusion The prognosis and death risk can be reviewed through detecting BNP and Hcy in elderly CHF patients,and at the sa

关 键 词：心力衰竭 血脂 胆固醇 同型半胱氨酸 冠心病 

分 类 号：R541.61[医药卫生—心血管疾病]