老年心力衰竭患者bnp、甲状腺

《老年心力衰竭患者bnp、甲状腺》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、浙江医学2017年第39卷第11期老年心力衰竭患者BNP、甲状腺激素水平变化对心功能及预后的影响李晓静杨军王健陈晓敏【摘要】目的分析老年心力衰竭患者脑钠肽（BNP）、甲状腺激素水平变化对心功能及预后的影响，以探讨测定BNP和甲状腺激素用于指导临床治疗的价值。方法选取老年心力衰竭患者88例为观察组，根据患者心功能情况分为玉~Ⅳ级4组，另外选取同期健康体检老年患者30例为对照组，测定所有入选者BNP和甲状腺激素水平。结果观察组BNP水平（694±128）pg/ml，高于对照组（32±14）pg/ml，FT3水平（3.16±0.85）pg/ml，低于对照组（5.63±0.8

2、1）pg/ml（均P＜0.01），FT4和促甲状腺激素（TSH）水平与对照组差异均无统计学意义（均P＞0.05）。随着心力衰竭程度的加重，FT3水平降低，BNP水平升高，不同程度心力衰竭患者FT3水平和BNP水平差异均有统计学意义（均P＜0.05）；存活者BNP水平（916.25±452.37）pg/ml，低于死亡者（2367.82±1002.24）pg/ml（P＜0.05），FT3水平（3.89±1.24）pmol/L，高于死亡者（2.67±0.85）pmol/L（P＜0.05）。患者BNP水平越高、FT3水平越低，死亡发生率越高。结论老年心力衰竭患者心力衰竭严重程

3、度可以采用测定BNP和甲状腺激素水平来评价，BNP降低、FT3升高可以作为预后良好的指标。【关键词】心力衰竭脑钠肽甲状腺激素预后EffectsofBNPandthyroidhormonelevelsoncardiacfunctionandprognosisinelderlypatientswithcongestiveheartfailureChina【Abstract】ObjectiveToinvestigatetheeffectofbrainnatriureticpeptide(BNP)andthyroidhormonelevelsoncardiacfunction

4、andprognosisinelderlypatientswithcongestiveheartfailure.MethodsEightyeightelderlypatientswithheartfailureadmittedinourhospitalfromMarch2015toJuly2013(studygroup),and30healthyagedsubjectsundergoinghealthcheck-upatthesameperiod(controlgroup)wereenrolledinthestudy.TheBNPandthyroidhormonele

5、velsweremeasuredintwogroups.ResultsBNPlevelinstudygroupwassignificantlyhigherthanthatincontrolgroup(694±128pg/mlvs.32±14pg/ml,P＜0.01);thelevelofFT3instudygroupwassignificantlylowerthanthatincontrolgroup(3.16±0.85pg/mlvs.5.63±0.81pg/ml,P＜0.01);therewasnosignificantdifferenceinFT4andTSH2l

6、evelsbetweentwogroups(P＞0.05).Withtheaggravationofheartfailure,thelevelofFT3wassignificantlydecreased,andthelevelofBNPwasgraduallyincreased;therewasasignificantdifferenceinFT3andBNPlevelsamongpatientswithdifferentcardiacfunctions(gradesI-IV,P＜0.05).TheBNPlevelinsurvivalpatientswassignif

7、icantlylowerthanthatinfatalpatients(916.25±452.37pg/mlvs.2367.82±1002.24pg/ml,P＜0.05),whiletheFT3levelinsurvivalgroupwassignificantlyhigherthanthatinfatalgroup(3.89±1.24pmol/Lvs.2.67±0.85pmol/L,P＜0.05).TheincidenceofmortalitywaspositivelyassociatedwithBNPlevelandnegativelyassoc