N末端B型利钠肽原与超声心动图及血气分析联合应用对急性左心衰患者诊断和预后的影响

发布时间：2018-02-15 05:27

本文关键词： N末端B型利钠肽原超声心动图血气分析急性左心衰诊断预后　出处：《苏州大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨联合运用N末端B型利钠肽原（N-terminal pro-B-typenatriuretic peptide，NT-proBNP）检测、超声心动图及血气分析对急性左心衰竭患者诊断价值及平均住院日和预后的影响。方法：以我院2008年1月至2010年6月NT-proBNP检测开展前收治的急性左心衰患者为A组（对照组1）（共96例），以我院2011年7月至2013年12月NT-proBNP检测开展后收治的急性左心衰患者为B组（实验组）（共98例），并以我院2011年7月至2013年12月NT-proBNP检测开展后因急性呼吸困难同时行NT-proBNP检测、超声心动图及血气分析排除急性左心衰患者为C组（对照组2）（共54例）。记录并分析后两组的诊断数据；对前两组患者随访6个月，比较前两组的平均住院日、再住院率、死亡率和人均住院费用。结果：联合应用NT-proBNP检测、超声心动图及血气分析诊断模式可取得93.4%对急性左心衰诊断准确性，高于联合应用NT-proBNP、超声心动图诊断准确性（90.1%）及单独使用NT-proBNP检测或超声心动图诊断准确性（分别是82.8%、76.3%）。B组平均住院日8.2±0.9天短于A组11.1±0.8天（P0．05）；B组再住院率9.2%、死亡率5.1%低于A组再住院率15.6%、死亡率9.4%（P0．05）；B组平均住院费用9324±462元低于A组12315±574元（P0．05）。结论：联合运用NT-proBNP检测、超声心动图及血气分析可提高急性左心衰诊断准确性，，并可降低急性左心衰患者平均住院日、改善预后并节省住院费用。
[Abstract]:Objective: to investigate the effect of N-terminal natriuretic peptide N-terminal pro-B-typenatriuretic peptiden (NT-proBNPP) combined with echocardiography and blood gas analysis on the diagnosis, mean hospitalization days and prognosis of patients with acute left heart failure (ARF). Methods: from January 2008 to June 2010, patients with acute left heart failure (AHF) treated in our hospital from January 2008 to June 2010 were selected as group A (control group 1) (96 cases). The patients treated with NT-proBNP from July 2011 to July 2011 were treated with acute left heart failure (AHF). The patients in group B (experimental group, 98 cases) were examined with NT-proBNP after NT-proBNP examination was carried out in our hospital from July 2011 to December 2013 because of acute dyspnea. Echocardiography and blood gas analysis excluded patients with acute left heart failure as group C (control group, n = 54). The diagnostic data of the latter two groups were recorded and analyzed. The patients in the first two groups were followed up for 6 months to compare the average days of hospitalization and the rate of re-hospitalization in the first two groups. Mortality and hospital expenses per capita. Results: 93.4% diagnostic accuracy of acute left heart failure could be obtained by combined use of NT-proBNP, echocardiography and blood gas analysis. The diagnostic accuracy of echocardiography was 90.1% higher than that of combined use of NT-proBNP and NT-proBNP alone or echocardiography (82.8% respectively). The average day of hospitalization in group B was 8.2 卤0.9 days shorter than that in group A (11.1 卤0.8 days). The rehospitalization rate of group B was lower than that of group A (5.1%). The mortality rate was 5.1% lower than that of group A. The average hospitalization cost of group B was 9324 卤462.It was lower than that of group A (12315 卤574 yuan). Conclusion: combined use of NT-proBNP, echocardiography and blood gas analysis can improve the diagnostic accuracy of acute left heart failure, reduce the average hospitalization days of patients with acute left heart failure, improve the prognosis and save hospital expenses.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R541.6

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