NT―proBNP对老年慢性心力衰竭患者再住院率及生存率影响.docVIP

NT―proBNP对老年慢性心力衰竭患者再住院率及生存率影响 　　摘要：目的 分析N-端脑利钠肽前体（NT-proBNP）水平与患者再住院率及生存率的关系，探讨NT-proBNP水平对慢性心力衰竭患者长期预后的预测价值。方法 选取2010年1月―2012年5月确诊为慢性心力衰竭的老年患者（60岁以上）共192例进行研究。所有患者均给予适当的抗心力衰竭治疗，比较治疗前后不同心功能分级患者的血浆NT-proBNP水平变化情况；并根据NT-proBNP水平由低至高将患者分为3组（A、B、C），随访两年，比较3组患者的再住院率及生存率，研究NT-proBNP与患者再住院率及生存率的关系。结果 治疗前，心力衰竭心功能分级越高，其NT-proBNP水平越高，但经抗心力衰竭治疗后NT-proBNP水平均显著降低（P0.01）；A组低NT-proBNP水平患者的再住院率最低，生存率最高，与B组、C组比较差异有统计学意义（P0.01）； NT-proBNP水平与患者的再住院率呈正相关（P0.05），而与患者的生存率则呈负相关（P0.05）。结论 NT-proBNP与慢性心力衰竭患者的再住院率及生存率密切相关，能为老年慢性心力衰竭患者预后评估及临床疗效评估提供客观的依据。 　　关键词： 慢性心力衰竭；N-端脑利钠肽前体；再住院率；生存率 　　中图分类号：R541 R256 文献标识码：A 　　Abstract：Objective To investigate the relationship between the level of the N-terminal pro-brain natriuretic peptide （NT-proBNP） with the readmission and survival rates，and to investigate the long-term prognosis predictive value of NT-proBNP level in patients with chronic heart failure（CHF）.Methods One hundred and ninety-two elderly patients with CHF were given appropriate anti-heart failure treatment.Before and after treatment，compared the changes of plasma NT-proBNP level in patients with various cardiac function.And divided the patients into group A， group B and group C according to the level of NT-proBNP from low to high.Followed-up for two-years，compared the readmission and survival rates of the three groups of patients.So that researched the relationship between the NT-proBNP with readmission and survival rates which could provide an objective basis for the risk assessment of prognosis and efficacy in patients.Results Before treatment，the higher cardiac function of heart failure，the higher level of NT-proBNP.But after the anti-heart failure treatment，the NT-proBNP level was significantly lower which difference was significant（P0.01）.The readmission rates of group A with low levels of NT-ProBNP was the lowest and the survival rates was the highest which has a significant difference compared with group B and C（P0.01）.The NT-proBNP level and the readmission rates was positi