慢性心力衰竭患者B型利钠肽及尿酸的变化及意义-内科学专业毕业论文.docxVIP

— — PAGE 1— 前 言 慢性心力衰竭患者 B 型利钠肽及 尿酸的变化及意义 研究生：邓勤 导师：木胡牙提 副教授 摘 要 目的：探讨血浆 B 型利钠肽(BNP)及血清尿酸浓度在慢性充血性心力衰竭(CHF) 时的变化，与心功能及超声心动图指标的相关性。方法：2007 年 3 月至 2008 年 5 月我院住院患者中,102 例因心功能失代偿而入院的 CHF 患者；非 CHF 组 26 例作为 对照组。患者入院后均行 BNP、尿酸和超声心动图检查，BNP 浓度以放射免疫法测 定，尿酸浓度以自动分析仪测定。CHF 组根据美国纽约心脏病协会(NYHA)心功能分 级标准分为Ⅱ、Ⅲ、Ⅳ级组。结果：CHF 时血浆 B 型利钠肽浓度及血清尿酸浓度随 心功能程度的加重而增高。心力衰竭程度重的（NYHAⅣ级及 NYHAⅢ级）患者的 血清尿酸浓度较心力衰竭程度轻的（NYHAⅡ级）和非 CHF 组高 (P0.01)。CHF 时 B 型利钠肽浓度与 NYHA 分级存在正相关关系(r=0.785,P0.01)；与左室射血分数存 在负相关关系 (r= -0.316，P0.01)。CHF 时尿酸浓度与 NYHA 分级存在正相关关系 (r=0.402，P0.01)；与左室射血分数无直线相关关系。结论：1.CHF 时血浆 B 型利钠 肽及血清尿酸浓度随着心力衰竭程度的加重而相应升高。B 型利钠肽与左心功能状 态有良好的相关性， 而尿酸的这种相关性较差。B 型利钠肽在诊断和评价心力衰竭 时优于尿酸。2.血清尿酸水平是反映 CHF 病情严重程度的一个有意义的指标，尤其 在心力衰竭程度重的（NYHAⅣ级及 NYHAⅢ级）患者更为明显。 关键词：心力衰竭;充血性;B 型利钠肽;尿酸 新疆医科大学硕士学位论文 Changing and Value of B-Type Natriuretic Peptide and Uric Acid Levels in Chronic Congestive Heart Failure Postgraduate student: Deng Qin Supervisor: Mu Huyati Vise professor Abstract Objective:To evaluate the changing of plasma B-type Natriuretic Peptide (BNP) and serum Uric Acid(UA) levels in chronic congestive heart failure(CHF)，and the relationship with heart function and index of echocardiogram. Methods:102 patients with decompensated CHF in hospitalization during March 2007 to May 2008. 26 patients without CHF were involved as control. Patients were evaluated with BNP,UA and echocardiogram.BNP was evaluated with radioimmunoassay. UA was evaluated with automatic analyse instrument. Patients with CHF were divided into Ⅱ ,Ⅲ ,Ⅳ class according to the cardiac functional grading standard of NYHA. Results:Plasma BNP and serum UA rised with deteriorate heart function. CHF patients with NYHAⅣor NYHAⅢ,had higher serum UA than CHF patients with NYHAⅡ and patients without CHF (P0.01). CHF patients’ Plasma BNP were significantly correlated with heart function (r=0.785,P0.01)， left ventricular ejection fraction (LVEF)( r= -0.316，P0.01). CHF patients’ Serum UA were correlated positively with heart function(r=0.402，P0.01) and