B型钠尿肽在心力衰竭诊治中应用研究.doc

B型钠尿肽在心力衰竭诊治中应用研究 　　【摘要】 目的：研究B型钠尿肽（BNP）评价心力衰竭患者心功能的价值。方法：收集本院慢性心力衰竭患者200例为观察组，同时选择健康者100例作为对照组。所有入组者治疗前后检查BNP、C反应蛋白（CRP）以及心脏超声，评估3个指标与心力衰竭病情发展的相关性。结果：（1）观察组BNP、CRP均高于对照组，LVEF低于对照组（P0.01）；（2）观察组治疗后2、4 d以及出院时BNP、CRP以及LVEF指标较治疗前均明显改善（P0.01）；（3）随着心功能受损程度加重，BNP和CRP均明显升高，LVEF指标明显下降（P0.05）。（4）对不同心功能分级与BNP、LVEF指标进行相关性分析，结果显示BNP与心功能分级呈正相关性（r=0.81，P0.01）；LVEF与心功能分级呈负相关性，（r=-0.53，P0.05）；LVEF与BNP之间呈负相关性（r=-0.78，P0.01）。（5）BNP的敏感性较高，特异性远低于其敏感性；心脏超声与CRP的特异性较BNP低。结论：BNP在心力衰竭诊治过程中有重要意义，临床上应结合BNP变化趋势指导心力衰竭诊治。 　　【关键词】 B型钠尿肽； 心力衰竭； 相关性 　　Research on Application of B-type Natriuretic Peptide in the Diagnosis and Treatment of Heart Failure/HUANG Ying-lan，CHEN Wen-zhi，XING Ri-kun，et al.//Medical Innovation of China，2015，12（15）：041-044 　　【Abstract】 Objective：To study the value of B- type natriuretic peptide（BNP） in the evaluation of cardiac function in patients with heart failure（HF）.Method：200 patients with chronic heart failure in our hospital were selected as observation group，and 100 healthy people were selected as control group.BNP，C reactive protein（CRP） and echocardiography of all subjects were examined before and after treatment.The relationship between the three indexes and development of heart failure was assessed.Result：（1） In observation group，BNP and CRP were higher， LVEF was lower than those in the control group（P0.01）.（2） In observation group， compared with before treatment， BNP，CRP and LVEF after treatment for 2 days， 4 days and at discharge were significantly improved（P0.01）.（3） With injury of cardiac function exacerbation， BNP and CRP were significantly increased，LVEF index decreased obviously（P0.05）.（4）There was a positive correlation between BNP and classification of cardiac function （r=0.81，P0.01），negative correlation between LVEF and classification of cardiac function（r=-0.53， P0.05），and negative correlation between LVEF and BNP（r=-0.78，P0.01）.（5）For BNP，the sensitivity was higher，and the specificity was far lower than the sensitivity； The specificities of echoc