心衰患者血浆脑钠肽与PiCCO心排量监测关系探讨.docVIP

心衰患者血浆脑钠肽与PiCCO心排量监测关系探讨 　　【摘要】 目的：研究分析心衰患者血浆脑钠肽与心排血量间的关系。方法：选择2009年4月-2015年4月在北京协和医院及岳阳市第一人民医院院进行治疗的72例心衰患者，根据入院第1天患者脑钠肽/脑钠肽正常高值的比值范围进行分组，比值2者38例BNP极高的患者作为研究组，比值2者34例BNP稍高的患者作为对照组，测定并分析两组患者血浆脑钠肽水平及PiCCO监测的心功能指数；根据患者治疗5 d后的心功能情况将72例患者分为Ⅱ～Ⅲ级和Ⅳ级，测定两组患者血浆脑钠肽水平及PiCCO监测的心功能指数。结果：研究组患者血浆脑钠肽水平（2479.35±302.77）pg/ml，明显高于对照组的（829.23±38.31）pg/ml（P0.05）；研究组心排血指数（CI）、每搏量指数（SVI）均明显低于对照组，差异均有统计学意义（P0.05）。且治疗5 d后心功能不同分级患者的血浆脑钠肽水平、CI、SVI等指标相比，差异均有统计学意义（P0.05）。结论：血浆脑钠肽与心排血量之间具有反比相关性，心衰程度严重者，心排血量更低，血浆脑钠肽水平更高。 　　【关键词】 血浆脑钠肽； PiCCO； 心排血量 　　中图分类号 R541.6 文献标识码 A 文章编号 1674-6805（2016）1-0001-02 　　【Abstract】 Objective：To explore the relationship between BNP and the cardiac output data from Pulse-indicated Continuous Cardiac Output（PiCCO） monitoring in heart failure patients.Method：72 heart failure patients in Peking Union Medical College Hospital and the First People’s Hospital of Yueyang City from April 2009 to April 2015 were involved in the retrospective analysis，they were classified as the research group of 38 cases，the control group of 34 cases according to the brain natriuretic peptide（BNP）/the highest normal value of BNP2 or not，hemodynamic data were recorded through continuous monitoring of PICCO，BNP of every patients were recorded at the same time，we analyzed the relationship between BNP and cardiac output.After 5-days-treatment，the patients were classified as the heart function of Ⅱ-Ⅲ level group of 40 cases，heart function of Ⅳ level group of 32 cases，we analyzed BNP and cardiac output of two group.Result：BNP of the research group （2479.35±302.77）pg/ml was higher than （829.23±38.31）pg/ml of the control group，the cardiac output index and the stroke volume index were lower than those of the control group，there were statistically significant（P0.05）.After 5-days-treatment，there were statistically significant in BNP and cardiac output between the heart function of Ⅱ-Ⅲ level and heart function of Ⅳ level（P0.05）.Conclusion：BNP has a inverse correlation with cardiac output.The more ser