The Study Of Relationship Between Plasma N-terminal Pro-brain Natriuretic Peptide(NT-proBNP) Levels And Heart Failure And Intervention With Recombinant Human Brain Natriuretic Peptide(rhBNP)

Objective:To investigate the relationship between plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) levels and the classification of heart failure,and the clinical value of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) levels in heart failure.And evaluate the effect of exogenous BNP during the treatment of patients with severe heart failure.Methods:Part One,we randomly selected into heart failure patients hospitalized in our department and patients without heart failure over the same period.The patients with acute myocardial infarction, malignant tumor, severe liver and kidney dysfunction, cerebrovascular disease, blood diseases and immune system diseases were excluded. Simultaneously,the plasma NT-proBNP level and general information about the two groups of patients (including age, gender), laboratory examinations (including ECG, chest X-ray film, echocardiography, etc.) results were recorded. Part Two, by a randomly selected into severe heart failure patients hospitalized in our department over the same period,we divided the patients into two groups.The patients with acute myocardial infarction, malignant tumor, severe liver and kidney dysfunction, cerebrovascular disease, blood diseases and immune system diseases were excluded.We collected general information about the two groups of patients (including age, gender), laboratory examinations (including ECG, chest X-ray film, echocardiography, etc.) results ,and LVEF,the plasma NT-proBNP levels before and after the treatments.Statistic analysis was made to explore the variance of data and the relationship between them by SPSS13.0 Stastistic Software. Results:1. Plasma NT-proBNP levels of patients with heart failure(median 9241.1pg/ml) was significantly higher than plasma NT-proBNP levels of patients without heart failure(median 309.5pg/ml), by non-parametric test Z=-7.129,P<0.05, the difference was statistically significant.2. The plasma NT-proBNP levels of patients in different classification of heart failure (NYHA classification as the standard) were different from each other,applying the rank sum testχ~2 =49.668, P = 0.000.The plasma NT-proBNP levels of patients with different heart failure NYHA classification had significant difference.3. Univariate and multivariate analysis suggested that the level of plasma NT-proBNP can be used in the diagnosis of heart failure as a more sensitive indicators of the independent reference.4. The correlation analysis suggested that plasma NT-proBNP levels and LVEF were negatively correlated (r =- 0.583, P = 0.000),while plasma NT-proBNP levels and the LAD were positively correlated (r =0.845, P = 0.000 <0.01).5. The results of the chi-square test suggested that the use of recombinant human brain natriuretic peptide based on the conventional therapy in severe heart failure patients can improve their prognosis.6. The results of t test of plasma NT-proBNP levels of different groups of patients suggested that the use of the recombinant human brain natriuretic peptide based on conventional therapy was significantly more effective( P <0.01).7. According to t test,LVEF of different groups of patients before and after treatment suggested that the use of the recombinant human brain natriuretic peptide combined conventional therapy was more effective in increase of LVEF in patients with severe heart failure.(P <0.05 )Conclusion:1. Plasma NT-proBNP levels can be used as a reference indicator of heart failure.2. Plasma NT-proBNP levels can be used as an independent sensitive indicators of heart failure diagnosis.3. Plasma NT-proBNP levels was negatively correlated with LVEF and positively correlated with LAD.4. The preliminary view that the clinical treatment of severe heart failure patients, in the conventional therapy based on the use of recombinant human brain natriuretic peptide can improve the prognosis of patients with heart failure. 5. Recombinant human brain natriuretic peptide combined conventional therapy in severe heart failure can be more effective in decrease of plasma NT-proBNP levels.6. Recombinant human brain natriuretic peptide combined conventional therapy in severe heart failure can be more effective in increase of LVEF in echocardiography.