脑钠肽和D二聚体对老年心功能不全严重程度的关系及预后的影响

目的：探讨BNP和D二聚体对老年心功能不全严重程度的关系及预后的影响。方法：以2010年1月-2012年12月来我院就诊的慢性心功能不全患者为观察对象，根据心功能不全程度分为无症状组、心功能不全II级、III级、IV级3，另取健康体检者为对照，比较各组间BNP、D二聚体水平及相关性分析。结果：各患者组BNP和D二聚体水平与对照组相比明显增加（P〈0．05）；BNP与心功能不全分级、LVEDD、LAD呈直线正相关关系（P〈0．05），与LVEF呈直线负相关关系（P〈0．05）；D二聚体与心功能不全分级、LVEDD呈直线正相关关系（P〈0．05），与LVEF呈呈直线负相关关系（P〈0．05），与LAD直线关系无统计学意义（P〉0．05）；BNP水平1000pg／mL以下治疗有效率80．2％，疗效优于1000pg／mL以上者（Riditz=15．245，P=0．000），D二聚体5μg／mL以下者治疗有效率85．4％，疗效优于5μg／mL以上者（Riditz=26．354，P=0．000）。结论：BNP和D二聚体与老年心功能不全严重程度和超声心动图指标密切相关，可以作为疾病预后预测。

Effect of Brain Natriuretic Peptide and D-dimer for the Prognosis of Elderly Patients with Cardiac Dysfunction

Objective： To investigate the relationship of BNP and D-dimer with the severity of senile cardiac function, and their effects on prognosis. Methods：In 2010 January-2012 December in our hospital, patients with chronic heart function insufficiency were selected as the observation object, and were divided into asymptomatic group, heart function not entire grade II, III and IV 3 groups according to the cardiac dysfunction, and another healthy subjects were used as control. Among groups, BNP, D-dimer analysis and correlati- on of body level were compared. Results： BNP and D-dimer levels of patients in these groups were significantly increased compared with those in the control group（P〈0.05）; there was a positive linear correlation between BNP and grade of cardiac insufficiency, LVEDD, LAD （P 〈0.05）, and was a linear negative correlation with LVEF （P〈0.05）; D-dimer had a linear positive correlation between body and mind insu- fficiency of grading, LVEDD （P〈0.05）, and had a linear negative correlation with LVEF （P〈0.05）, had no significant linear relationship with LAD （P〉0.05）; the effective rate of treatment was 80.2% below 1000 pg/ml of BNP level, curative effect is better than that with more than 1000 pg/mL （Ridit z=15.245, P=0.000）, the effective rate of treatment was 85.4% under 5 μg/mL of D-dimer, curative effect is better than that of 5 μg/mL above （Ridit z=26.354, P=0.000）. Conclusion： BNP, D-dimer, senile heart failure severity and ultrasound heartbeat graph indexes were closely related to each other, can be used as a predicting disease prognosis