血浆脑钠肽水平与老年非心脏手术后呼吸困难及心血管事件的关系

发布时间：2018-02-22 13:28

本文关键词： 脑钠肽非心脏手术呼吸困难心血管事件　出处：《中国老年学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨血浆脑钠肽(BNP)水平与老年非心脏手术后呼吸困难及心血管事件的关系。方法选择2015年7月至2016年5月该院收治的老年患者96例,根据心电图及胸片等诊断结果分为非心源性呼吸困难组(非心源性组,n=60)和心源性呼吸困难组(心源性组,n=36)。检测患者血浆中BNP水平及肺功能、心功能相关指标水平,另外术后随访半年,统计患者心血管事件发生情况,分析BNP水平与肺功能、心功能相关指标的关系。对血浆BNP及检测指标进行相关性分析。结果心源性组血浆BNP水平明显高于非心源性组(t=-8.688,P=0.000);与非心源性组相比,心源性组血氧分压(PaO_2)、每搏输出量(SV)、左室射血分数(LVEF)水平及6 min步行试验(6MWT)明显下降(P0.05),而血二氧化碳分压(PaCO_2)、第1秒用力呼气容积值(FEV1)、FEV1占用力肺活量(FVC)百分比(FEV1/FVC)、左心室舒张末径(LVEDD)、心肌肌钙蛋白(cTn)I水平及心血管事件发生率显著升高(P0.05);Pearson相关性分析中血浆BNP水平与PaCO_2、FEV1、FEV1/FVC、6MWT、LVEDD、cTnI及心血管事件发生率呈正相关(P0.05),而与Pa O2、SV及LVEF水平呈负相关(P0.05)。结论心源性呼吸困难患者血浆中BNP水平异常升高,BNP水平与呼吸功能及心功能相关指标联系密切,临床上对于诊断不同类型的呼吸困难具有重要作用,并为治疗老年非心脏手术患者的治疗提供理论依据。
[Abstract]:Objective to investigate the relationship between plasma brain natriuretic peptide (BNP) level and dyspnea and cardiovascular events in elderly patients after non-cardiac surgery. Methods 96 elderly patients treated in our hospital from July 2015 to May 2016 were selected. According to the results of electrocardiogram and chest radiography, the patients were divided into two groups: non-cardiogenic dyspnea group (non-cardiogenic group) and cardiogenic dyspnea group (cardiogenic group). The plasma levels of BNP, pulmonary function and cardiac function were measured. In addition, the patients were followed up for half a year. The incidence of cardiovascular events, BNP level and lung function were analyzed. Correlation analysis of plasma BNP and detection indexes. Results the level of plasma BNP in cardiogenic group was significantly higher than that in non-cardiogenic group (P < 0.01), and was significantly higher than that in non-cardiogenic group (P < 0.05). In cardiogenic group, Pao _ 2, SVV, LVEF (left ventricular ejection fraction) and 6 min walking test (6 min walking test) decreased significantly (P 0.05), and PaCO _ 2, FEV _ 1FEV _ 1 occupied vital capacity (FEV _ 1 / FVC), FEV _ 1 / FV _ (2), FEV _ 1 / F _ V _ (2), FEV _ 1 / F _ V _ (1), FEV _ 1 / F _ V _ (1), FEV _ 1 / F _ (V _ C), FEV _ 1 / F _ V _ (1), FEV _ 1 / F _ V _ (1). The level of cardiac troponin I and the incidence of cardiovascular events were significantly increased. In Pearson correlation analysis, plasma BNP level was positively correlated with Paco _ 2FEV _ (1) FEV _ (1) / FVC _ (C6) MWTT LVEDDD _ (cTnI) and cardiovascular events (P _ (0.05)), but negatively correlated with Pa _ (2) O _ (2) SV and LVEF levels. The abnormal increase of plasma BNP level in patients with cardiogenic dyspnea is closely related to respiratory function and cardiac function. It plays an important role in the diagnosis of different types of dyspnea and provides a theoretical basis for the treatment of elderly patients with non-cardiac surgery.
【作者单位】：河北医科大学第四医院心内科;河北医科大学第四医院肿瘤内科;石家庄市警备区第一干休所;
【基金】：河北省卫生厅医学科学研究重点课题(No.20100438)
【分类号】：R54

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