慢性心力衰竭维吾尔医异常体液分型与BNP、左心功能相关性研究

发布时间：2018-07-16 16:19

【摘要】：目的:1.探讨不同维吾尔医辩证分型慢性心力衰竭(CHF)患者脑钠肽(BNP)和左心功能指标(NYHA分级、LVEF值)之间的变化规律。2.研究CHF患者BNP与心功能分级(NYHA分级)、LVEF值之间的关系。方法:通过前瞻性研究收集自治区维吾尔医医院急诊科及心内科2015年8月到2016年3月的慢性心力衰竭患者80例,采集病例症状、体征与实验室检查结果等资料,根据症候资料将病例分为异常胆液质型、异常血液质型、异常粘液质型及异常黑胆质型四个组,进行心功能分级,BNP,LVEF指标的检测,对数值资料进行方差分析,对分类资料进行卡方检验等。结果:1.慢性心衰维吾尔医辩证分型与心功能指标(NYHA分级,LVEF值)和BNP值密切相关。随着证型从异常胆液质型-血液质型-异常粘液质型-至异常黑胆质型,NYHA心功能级别和BNP值相应的升高,而LVEF值相应的降低。2.不同证型之间BNP值有显著性差异(P0.01)。与异常胆液质型、异常血液质型及异常粘液质型相比异常黑胆质型CHF患者血浆BNP值显著升高(P0.01)。异常胆液质型、异常血液质型、异常粘液质型的BNP值之间无显著性差异(P0.05)。3.不同心功能级别组之间BNP值及LVEF值均存在显著性差异(P0.05),且随着心衰级别的增加,LVEF值相应降低,BNP值相应升高。4.LVEF值与BNP值之间呈负相关,但关联程度不强(R2=0.143,r=0.378),本项研究中不支持用LVEF值来预测BNP值的结果。结论:1.BNP和心功能指标(NYHA分级、LVEF值)可作为维吾尔医辨证分型的参考,随着证型从异常胆液质型-异常血液质型-异常粘液质型至异常黑胆质型,心功能(NYHA级别)和BNP值相应的升高,而LVEF值则相应的降低。2.随着心功能的下降(NYHA分级的升高),LVEF值相应降低,BNP值相应升高。LVEF值与BNP值呈负相关,但二者之间相关性并不强,本研究中不支持用LVEF值来预测BNP值的结果。
[Abstract]:Purpose 1. To investigate the changes of brain natriuretic peptide (BNP) and left ventricular function index (NYHA grading LVEF) in patients with chronic heart failure (CHF). To study the relationship between BNP and LVEF in patients with CHF. Methods: 80 patients with chronic heart failure (CHF) from August 2015 to March 2016 were collected from the emergency department of Uygur Medical Hospital and the Department of Cardiology of the Uygur Medical Hospital. According to the symptom data, the patients were divided into four groups: abnormal bile fluid type, abnormal blood type, abnormal mucous type and abnormal black bile type. Carry on chi-square inspection to the classified data and so on. The result is 1: 1. The dialectical classification of Uygur doctors with chronic heart failure was closely related to cardiac function index (NYHA grade LVEF value) and BNP value. With the increase of NYHA and BNP in the syndromes from abnormal bile fluid type, blood type, abnormal mucus type to abnormal black gallbladder type, LVEF decreased by 0.2. There was significant difference in BNP between different syndromes (P 0.01). Compared with abnormal biliary fluid type, abnormal blood type and abnormal mucus type, the plasma BNP value of CHF patients with abnormal melanoglastic type was significantly higher (P0.01). There was no significant difference in BNP between abnormal bile fluid type, abnormal blood type and abnormal mucous type (P0.05). There was significant difference in BNP value and LVEF value among different cardiac function grade groups (P0.05), and with the increase of heart failure grade, LVEF value decreased correspondingly. 4. There was a negative correlation between BNP value and LVEF value. However, the degree of correlation is not strong (R2O0.143 / RP0.378). In this study, we do not support the use of LVEF to predict the results of BNP. Conclusion 1. BNP and cardiac function index (NYHA grading and LVEF) can be used as a reference for differential classification of Uygur's syndrome, with the syndromes ranging from abnormal bile fluid type, abnormal blood type, abnormal mucous type to abnormal black gallbladder type. Cardiac function (NYHA grade) and BNP increased correspondingly, while LVEF decreased by 0.2. With the decrease of cardiac function (NYHA grade), LVEF value decreased correspondingly. The value of BNP increased. LVEF value was negatively correlated with BNP value, but the correlation between them was not strong. In this study, we do not support the use of LVEF value to predict the results of BNP value.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R29

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