血BNP 监测对慢性心力衰竭患者治疗的指导价值及其对预后 的影响研究

目的:探讨血浆脑钠肽(BNP)监测对慢性心力衰竭(CHF)患者治疗的指导价值及其对预后的影响。方法:根据出院后是否进行BNP监测,将2009年5月至2010年12月我院心内科出院的CHF患者100例随机分为监测组和对照组,每组各50例。平均随访时间为1年,观察两组的治疗效果和预后包括心血管性死亡、因心血管事件再次住院例数、NYHA心功能分级、明尼苏达心衰生活质量问卷(MLHFQ)评分。结果:随访1年期间,监测组心血管性死亡率、因心血管事件再次住院率分别为2%、18.0%,对照组分别为16.0%、54.0%,差异均有统计学意义(P<0.05)。出院时与第1次随访,两组患者明尼苏达心衰生活质量问卷评分结果比较差异无统计学意义(P>0.05);而第2、3、4次随访时,监测组试验结果均显著高于对照组,差异有统计学意义(P<0.05)。随访1年时,监测组患者的NYHA心功能分级、抗心衰药物的靶剂量率显著优于对照组,差异有统计学意义(P<0.05)。结论:通过血浆BNP水平监测,及时调整治疗方案,可延缓心衰的进展,改善患者预后。

The Guidance Value and Prognostic Influence of Serum BNP Monitoring in Patients with Chronic Heart Failure

Objective: To explore the guidance value and prognostic influence of serum brain natriuretic peptide(BNP) monitoring in patients with chronic heart failure(CHF).Methods: According to whether having BNP monitoring or not,100 cases of CHF were divided into two groups,including 50 cases of monitoring group and 50 cases of control group.All the patients were followed-up for 1 year on average,the effect and prognosis including cardiac death,cases of cardiac readmission,NYHA heart function classification and MLHFQ were observed and analyzed.Results: During the 1 year follow-up,the rates of death and cardiac readmission in monitoring group(2%,18.0%) were significantly lower that in control group(16.0%,54.0%)(P<0.05).At discharge and first time follow-up,there were no signif-icant difference on MLHFQ between the two groups(P<0.05),but the result of MLHFQ was significant higher in monitoring group than that in control group at second,third and fourth time follow-up(P<0.05).The NYHA heart function classification and rate of patients re-ceiving target dosage of drugs in monitoring group was better than that in control group at fourth time follow-up,the difference was sta-tistically significant(P<0.05).Conclusions: Adjusting the treatment timely by serum BNP monitoring can contribute to slow the develop-ment of CHF and improve the prognosis.