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目的分析血清脑钠肽(BNP)、甲状腺激素水平与慢性心力衰竭患者心功能及预后的相关性。方法选择2014年5月-2015年12月心内科住院收治的80例老年慢性心力衰竭患者为研究对象,测定患者血清脑钠肽、血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、左室射血分数(LVEF)水平。根据心功能分级分为心功能Ⅱ级(19例)、心功能Ⅲ级(28例)、心功能Ⅳ级(33例),根据住院期间患者心血管事件发生情况分为非心血管事件组(n=26)和心血管事件组(n=54),比较各组间相关指标的变化情况。结果与心功能Ⅱ级组比较,Ⅲ级、Ⅳ级组患者BNP水平明显升高,T3、FT3、FT4、LVEF明显降低(P<0.05);与心功能Ⅲ级组比较,Ⅳ级组患者BNP水平明显升高,T3、FT3、FT4、LVEF明显降低(P<0.05);非心血管事件组患者BNP水平显著低于心血管事件组,T3、FT3水平显著高于心血管事件组(P<0.05);LVEF与BNP呈负相关(r=-0.512,P<0.05),与T3、FT3呈正相关(r=0.422、0.231,P<0.05)。结论血清脑钠肽、甲状腺激素水平与老年慢性心力衰竭患者心功能相关。
Objective To analyze the relationship between serum brain natriuretic peptide (BNP), thyroid hormone levels and cardiac function and prognosis in patients with chronic heart failure. Methods Eighty elderly patients with chronic heart failure were enrolled in our department from May 2014 to December 2015 in our hospital. Serum brain natriuretic peptide, serum triiodothyronine (T3), thyroxine (T4) , Free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH) and left ventricular ejection fraction (LVEF). According to the classification of cardiac function, the patients were divided into two groups according to the grade of cardiac function: grade Ⅱ (19 cases), grade Ⅲ (28 cases), grade Ⅳ (33 cases). According to the occurrence of cardiovascular events during hospitalization, n = 26) and cardiovascular events group (n = 54). The changes of related indicators in each group were compared. Results Compared with grade Ⅱ group, BNP level was significantly increased and T3, FT3, FT4 and LVEF were significantly decreased in grade Ⅲ and Ⅳ group (P <0.05). Compared with grade Ⅲ group, BNP (P <0.05). The BNP levels in non-cardiovascular events group were significantly lower than those in cardiovascular events group, while the levels of T3 and FT3 in cardiovascular events group were significantly higher than those in cardiovascular events group (P < 0.05). LVEF was negatively correlated with BNP (r = -0.512, P <0.05), positively correlated with T3 and FT3 (r = 0.422,0.231, P <0.05). Conclusions Serum brain natriuretic peptide and thyroid hormone levels are associated with cardiac function in elderly patients with chronic heart failure.