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目的 探讨快速测定脑利钠肽预测充血性心力衰竭近期预后的价值。方法 70例充血性心力衰竭住院患者 ,NYHA心功能Ⅲ级 3 7例、Ⅳ级 3 3例。入院时、出院前或临终前 2 4小时内分别测定血浆BNP ,分析住院治疗前后BNP水平变化与心源性死亡、3 0天内再住院事件的关系。结果 2 3例患者出现终点事件 (因心功能恶化死亡 6例、再住院 17例 ) ,其入院时BNP水平 ( 15 16pg/ml± 872pg/ml)高于未发生临床终点者 ( 10 3 7pg/ml± 65 4pg/ml) ,P <0 .0 1;发生临床终点者住院期间BNP升高 3 18pg/ml ,而未发生终点事件的患者 ,住院期间BNP平均降低 3 5 9pg/ml ,P <0 .0 1;BNP升高组患者发生临床终点 68.2 % ,BNP降低组患者发生临床终点 16.7% ,P <0 .0 0 5。结论 BNP水平可预测失代偿充血性心力衰竭患者的近期预后
Objective To investigate the value of rapid determination of brain natriuretic peptide in predicting the short-term prognosis of congestive heart failure. Methods Seventy patients with congestive heart failure were enrolled in this study. Cardiac function was NYHA class 37 (grade Ⅲ) and grade Ⅳ (33). Plasma BNP levels were measured at admission, before discharge or 24 hours before dying, and the association between changes in BNP levels before and after hospitalization and cardioembolic death and rehospitalization events within 30 days was analyzed. Results Twenty-three patients had an end-point event (6 deaths due to worsening cardiac function and 17 rehospitalization). BNP levels at admission (15 16 pg / ml ± 872 pg / ml) were higher than those without clinical end points (10 3 7 pg / ml ± 65 4 pg / ml), P <0.01; BNP increased by 3 18 pg / ml during the hospitalization period in patients with clinical end points, while BNP decreased by 359 pg / ml on average during hospitalization, P < 0 .0 1; 68.2% of patients in the BNP increased group, and 16.7% of the patients in the BNP reduced group, P <0.05. Conclusions BNP levels predict the short-term prognosis of patients with decompensated congestive heart failure