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目的通过对扩张型心肌病(DCM)患者B型脑钠肽(BNP)检测及随访研究,探讨BNP对DCM预后判断和危险分层方面的应用价值。方法对120例DCM患者(D组)、54例正常对照者(C组),入院时检测血浆BNP及心脏超声指标,并进行对比观察,随访患者心脏事件的再发生情况。结果 D组BNP浓度均明显高于C组(P<0.01),BNP浓度与NYHA心功能分级成正比,单变量和Cox模型多变量回归分析显示,入院时BNP的浓度检测可以作为心脏事件发生的独立预测指标。入院时BNP≥721.3pg/ml,LVEF≤36%的患者,因心脏事件死亡和再次住院率提高。结论检测血浆BNP浓度对于判断DCM患者病情严重程度及预后有重要意义,入院时BNP的浓度结合心脏超声指标能够较好的评估心脏事件的发生风险。
Objective To explore the clinical value of BNP in the prognosis and risk stratification of DCM by detecting and observing type B BNP in patients with dilated cardiomyopathy (DCM). Methods 120 patients with DCM (group D) and 54 normal controls (group C) were enrolled in the study. Plasma BNP and echocardiographic parameters were measured at admission and compared with each other. The recurrence of cardiac events was followed up. Results The concentration of BNP in group D was significantly higher than that in group C (P <0.01). BNP concentration was positively correlated with NYHA functional classification. Multivariate regression analysis of univariate and Cox models showed that concentration of BNP on admission could be used as a cardiac event Independent predictors. At admission BNP ≥721.3pg / ml, LVEF ≤ 36% of patients died of cardiac events and re-hospitalization rate increased. Conclusions The detection of plasma BNP concentration is of great significance for judging the severity and prognosis of patients with DCM. The concentration of BNP on admission combined with echocardiography can better assess the risk of cardiac events.