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目的比较尿毒症合并急性左心力衰竭时左室射血分数(left ventricular election fraction,LVEF)和血浆氮末端脑钠肽(n-terminal brain natriuretic peptide,NT-BNP)水平的变化特点。方法选择2005年1月—2016年6月收治的尿毒症合并急性左心力衰竭患者145例,根据急性左心功能不全的严重程度分为第Ⅰ组双肺有哮鸣音无湿啰音患者46例,第Ⅱ组双肺哮鸣音并肺下半肺湿啰音患者57例,第Ⅲ组大部分肺布满哮鸣音和湿啰音患者42例,分别测定LVEF和NTBNP水平,用统计学方法比较各组变化特点,并计算其相关性,P<0.05为差异有统计学意义。结果 NT-BNPⅡ组和Ⅲ组与Ⅰ组比较分别为(1 468.04±89.75)ng/L和(1203.96±74.56)ng/L,(1 620.49±80.02)ng/L和(1 203.96±74.56)ng/L,Ⅲ组与Ⅱ组比较分别为(1 620.49±80.02)ng/L、(1 468.04±89.75)ng/L,以上组间比较差异均有统计学意义(均P<0.05);LVEFⅢ组与Ⅰ组+Ⅱ组分别为(36.13±4.68)%、(47.46±3.21)%,组间比较差异均有统计学意义(均P<0.05);Ⅲ组NT-BNP与LVEF呈现负相关(rs=-0.39 8,P<0.05),Ⅰ组+Ⅱ组NT-BNP与LVEF无相关性(rs=-0.12,P>0.05)。结论诊断、评估尿毒症合并急性左心力衰竭的轻中度患者应着重观察氮末端脑钠肽水平,重度患者应兼顾LVEF和NT-BNP的指标。
Objective To compare the changes of left ventricular ejection fraction (LVEF) and plasma n-terminal brain natriuretic peptide (NT-BNP) in uremic patients with acute left heart failure. Methods A total of 145 uremic patients with acute left heart failure admitted to our hospital from January 2005 to June 2016 were divided into two groups according to the severity of acute left ventricular dysfunction: wheezing without wheeze For example, in group Ⅱ, 57 patients had bilateral lung wheeze and lungs with lower lung araera, and most of lungs in group Ⅲ had 42 patients with wheeze and wet rales. LVEF and NTBNP levels were measured by statistics Learning methods to compare the characteristics of each group changes, and calculate the correlation, P <0.05 for the difference was statistically significant. Results The levels of NT-BNPⅡ and Ⅲ were (1 468.04 ± 89.75) ng / L and (1203.96 ± 74.56) ng / L, (1 620.49 ± 80.02) ng / L and (1 203.96 ± 74.56) ng (P <0.05). There was significant difference between the two groups (all P <0.05). The levels of IL-6 in LVEF group (36.13 ± 4.68)% and (47.46 ± 3.21)% respectively in group Ⅰ and group Ⅱ (all P <0.05). There was a negative correlation between NT-BNP and LVEF in group Ⅲ = -0.39 8, P <0.05). There was no correlation between NT-BNP and LVEF in group Ⅰ and group Ⅱ (rs = -0.12, P> 0.05). Conclusions It is important to observe the level of N-terminal pro-brain natriuretic peptide in patients with mild to moderate diagnosis and evaluation of uremia with acute left heart failure. Patients with severe disease should take into account the indicators of LVEF and NT-BNP.