论文部分内容阅读
目的通过对心力衰竭(CHF)患者脉搏波传导速度(PWV)的测量,评价心力衰竭患者脉搏波传导速度与脑钠肽(BNP)以及心功能不全的关系。评价动脉僵硬度对心功能的影响,对临床工作给予一定的理论指导。方法选取CHF患者103例,使用VP-1000动脉硬化测定仪测量患者脉搏波传导速度,使用多普勒超声心动图测定CHF组左室舒张末期内径(LVEDD)及左室射血分数(LVEF),评价患者心功能,应用微粒子酶联免疫化学发光法(MEIA)测定BNP,收集数据完成后,使用SPSS12.0统计软件进行统计分析。结果CHF患者血浆BNP水平(4200±160)pg/ml,较对照组(600±20)pg/ml明显升高(P<0.01);不同心功能患者血浆BNP水平差异亦有统计学意义,依次为Ⅳ级>Ⅲ级>Ⅱ级>Ⅰ级(P<0.01);LVEDD≥60mm时的BNP与LVEDD<60mm时比较差异有统计学意义(P<0.01);LVEF<40%时的BNP与LVEF≥40%时比较差异有统计学意义(P<0.01);CHF组BNP水平升高与心力衰竭程度、LVEDD呈正相关(r=0.87、r=0.67,P<0.01);与LVEF呈负相关(r=-0.53,P<0.01)。PWV是心功能的独立影响因素(P<0.01)。结论BNP与用多普勒心脏超声所评估的心脏功能参数LVEDD、LVEF具有相关性,对于CHF患者是一种危险因素。PWV对于BNP和心脏功能是独立决定因素。
Objective To evaluate the relationship between pulse wave velocity and brain natriuretic peptide (BNP) and cardiac insufficiency in heart failure patients by measuring pulse wave velocity (PWV) in patients with heart failure. Evaluate the influence of arterial stiffness on cardiac function and give some theoretical guidance to clinical work. Methods 103 patients with CHF were selected. The pulse wave velocity was measured by VP-1000 arterial stiffness meter. Left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were measured by Doppler echocardiography. The cardiac function of patients was evaluated. BNP was measured by MEIA. After the data were collected, the data were analyzed by SPSS 12.0 statistical software. Results Plasma BNP level in patients with CHF was 4200 ± 160 pg / ml, which was significantly higher than that in the control group (600 ± 20) pg / ml (P <0.01). There was also a significant difference in plasma BNP levels between patients with different cardiac functions (P <0.01). There was significant difference between LVEDD <60mm and LVEDD <60mm when the LVEDD≥60mm (P <0.01), BNP and LVEF (P <0.01). The increase of BNP in CHF group was positively correlated with the level of heart failure and LVEDD (r = 0.87, r = 0.67, P <0.01), but negatively correlated with LVEF r = -0.53, P <0.01). PWV is an independent factor of cardiac function (P <0.01). Conclusions BNP is associated with LVEDD and LVEF, as assessed by Doppler echocardiography, and is a risk factor for CHF. PWV is an independent determinant of BNP and cardiac function.