论文部分内容阅读
目的探讨N端前脑钠肽(NT-pro BNP)水平动态监测在妊娠期高血压疾病(HDCP)患者中的临床价值。方法回顾性分析2013年12月-2016年12月该院收治的177例HDCP患者,按照心功能级别不同把患者分为心功能Ⅰ级127例为正常组,Ⅱ、Ⅲ、Ⅳ级共50例为异常组,对比心功能不同级别NT-pro BNP水平、病情不同程度NT-pro BNP水平,比较正常组与异常组两组左室舒张功能情况。结果患者基本临床表现主要有:水肿、高血压、蛋白尿、子痫抽搐、呼吸困难等;在不同级别心功能NT-pro BNP水平对比上,组间差异有统计学意义(F=1.36,P<0.05),且随着心功能异常级别的增高NT-pro BNP水平逐渐升高;在不同程度病情NT-pro BNP水平对比上,妊娠期高血压、轻度子痫前期、重度子痫前期、子痫组间比较差异有统计学意义(F=0.59,P<0.05),且随着病情严重程度的加重NT-pro BNP水平逐渐升高;在不同时期正常组和异常组NT-pro BNP水平对比上,正常组和异常组在早期妊娠、晚期妊娠、产后3个时期差异有统计学意义(均P<0.05);正常组与异常组两组左室舒张功能比较,早期充盈峰(E)、晚期充盈峰(A)、E峰速度时间积分(EVTI)、A峰速度时间积分(AVTI)差异有统计学意义(均P<0.05)。结论 NT-pro BNP水平动态监测能够反映不同时期HDCP患者的病情严重程度以及心功能受损程度,且随着心功能异常级别的增高NT-pro BNP水平升高,患者病情可能越重,越容易出现心功能不全,因此可在临床上应用NT-pro BNP水平动态监测HDCP患者的心功能以及病情程度。
Objective To investigate the clinical value of dynamic monitoring of N-terminal pro-brain natriuretic peptide (NT-pro BNP) level in patients with gestational hypertension (HDCP). Methods A retrospective analysis of 177 HDCP patients admitted from December 2013 to December 2016 in our hospital was performed. According to the different cardiac function, 127 patients with grade Ⅰ cardiac function were divided into normal group, 50 patients with grade Ⅱ, Ⅲ and Ⅳ As the abnormal group, NT-pro BNP level and NT-pro BNP level were compared between different levels of cardiac function, and the left ventricular diastolic function was compared between normal group and abnormal group. Results The basic clinical manifestations of patients were as follows: edema, hypertension, proteinuria, seizures and dyspnea, etc. There was significant difference between groups in the levels of NT-pro BNP (F = 1.36, P <0.05), and the level of NT-pro BNP gradually increased with the increase of abnormal cardiac function. Compared with the levels of NT-pro BNP in different degrees, the incidence of gestational hypertension, mild preeclampsia, severe preeclampsia, The levels of NT-pro BNP in the eclampsia group were significantly higher than those in the control group (F = 0.59, P <0.05). The levels of NT-pro BNP gradually increased with the severity of the disease. In contrast, there was significant difference between the normal group and the abnormal group in early pregnancy, late pregnancy and postpartum period (all P <0.05). Compared with normal group and abnormal group, left ventricular diastolic function, early filling peak (E) , Late filling peak (A), E peak time integral (EVTI), A peak temporal integral (AVTI) were significantly different (all P <0.05). Conclusion The dynamic monitoring of NT-pro BNP level can reflect the severity of HDCP patients and the extent of cardiac dysfunction in different periods. And with the increase of NT-pro BNP level, the patients may be more serious and easier Heart failure occurs, so the clinical application of NT-pro BNP levels in HDCP patients with dynamic monitoring of heart function and extent of illness.