摘要
目的:探讨老年男性慢性心衰患者在经过标准化抗心衰治疗后的血浆脑利钠肽水平的分布及其影响因素。方法:选取我院高干病房心内科65例老年男性慢性心衰患者,收集患者一般资料、入院后检查结果及药物治疗情况,包括:年龄、有无心衰相关性疾病(高血压、糖尿病、冠心病、肾功能不全)、入院时心率、血压,入院后血肌酐、电解质、胸片有无肺淤血、超声心动图指标(ESV,EDV,EF)、出院前血浆BNP水平以及住院期间的药物治疗情况(主要指β-受体阻滞剂,ACEI或者ARB,强心剂、利尿剂等)。住院期间给予标准化抗心衰治疗并在出院前检测血浆BNP水平,按BNP水平将患者分成高BNP组(BNP>463 pg/ml)和正常BNP组(BNP≤463 pg/ml),比较两组间各研究因素分布有无差异,并对BNP水平与各因素之间的相关性进行统计分析。结果:经过标准化抗心衰治疗,出院时高BNP组患者44例(67.69%),这部分患者更多的伴有血压低、心率快、高肺动脉压、肺淤血的胸片表现。同时还发现高BNP组的患者中房颤及冠心病的发病率也偏高。对BNP的影响因素进行多元线性回归分析后得出房颤、低收缩压、肺淤血、高肌酐为出院时高BNP水平的影响因素。结论:在不同BNP分组中多个研究因素的分布有显著统计学差异,提示老年男性慢性心衰患者伴有低血压、房颤、高肌酐、肺淤血是出院时高血浆BNP的危险因素,需要给予密切的医疗关注和治疗。
Objective： To study the distribution and the influencing factors of plasma brain natriuretic peptide levels for older male patients with chronic heart failure after standard resisted treatment for heart failure. Methods： Select 65 elderly cases of male patients with chronic heart failure, and collect patients＇ general information, test results and drug treatment, including： age, with or without heart failure correlation disease （high blood pressure, diabetes, coronary heart disease, renal insufficiency）, hospitalized heart rate, blood pressure, serum creatinine, electrolyte, chest radiograph with or without pulmonary congestion, ultrasonic cardiogram index （ESV, EDV, EF）, blood plasma BNP level before discharge and drug treatment in hospital （mainly refers to the beta blockers, ACEI or ARB, cardiac, diuretics, etc.）. While in hospital, patients were given standard anti- heart failure treatment and had blood plasma BNP level test before leave hospital. According to the BNP level, patients were divided into high BNP group （BNP〉463 pg/ml） and normal BNP group （BNP acuities 463 pg/ml）. Compared the distribution factors between 2 groups, and statistically analyzed the BNP level and the relationship between various factors. Results： After standard resisted treatment for heart failure, 44 patients in high BNP groups （67.69 %） were with more low blood pressure, fast heart rate, high pulmonary artery pressure and pulmonary gore chest films performance. It is also found that the incidence of coronary heart disease of the patients in high BNP group is on the high side. After multiple linear regression analysis of influence factors of BNP, atrial fibrillation, lower systolic blood pressure, lung congestion, and high creatinine are the influence factors of high BNP level while discharging hospital. Conclusion： Multiple research factors in different BNP groups have statistically significant difference between the distribution, indicating that low blood, atrial fibrillation, high creatinine, lung congestion are the risk factors of high discharge plasma BNP for older male patients with chronic heart failure, and require a close attention and medical treatment.
出处
《现代生物医学进展》
CAS
2013年第6期1121-1125,共5页
Progress in Modern Biomedicine
关键词
老年
心衰
BNP
影响因素
Elderly men
Heart failure
BNP
Prognostic factors
