| Objective: To investigate the level of NT-pro BNP, blood uric acid, renal function and heart function classification in patients with chronic heart failure, and on patients with chronic heart failure severity and prognosis evaluation value.Methods:1. C hoose from June 2014 to December 2015 in the hospital of 118 cases of chronic heart failure, male 54, female 64 cases, age 37-93 years old, average 73.44±10.67 years old. According to the NYHA standard to carry on the heart function grouping, divides into the cardiac function I class 26 people, the second class 36 people, the third class 31 people, the fourth grade 25 people.2. All enrolled patients in hospital the following morning extraction fasting venous blood 2ml injection anticoagulation tube, within 2 hours of determination of plasma NT pro BNP concentration; ultrasound echocardiography to check the map calculated left ventricular ejection ejection fraction(LVEF); were admitted to the hospital the next morning on an empty stomach pumped blood determinat ion of blood biochemical indices(including UA, Cr, BUN, GLU, TG, TC, LDL-C and HDL-C etc.).3.Follow- up: Follow-up for each patient during hospitalization and after discharge from hospital with in 6 months of major adverse cardiac events, including recurrent congestive heart failure and cardiogenic sudden death, angina, myocardial infarction, heart failure patients were divided into group event and non event group, a comparison was made on the changes in the concentration of plasma NT pro BNP before and aft er.Results: 1. Heart function I, II, III and IV respectively in plasma level of NT-pro BNP(257.19±76.06) pg/ml,(1385.47±544.54) pg / ml,( 4374.51±1886.90) pg / ml,(12350.72±4881.42) pg / ml, the difference between the two groups has statistical significance( P < 0.05). The higher the heart function classification, the higher the level of plasma NT-pro BNP, and showed an upward trend. In 118 patients, different LVEF values by 45% as the boundary values divided into two groups. Left ventricular ejection fraction(LVEF) is more than or equal to 45% of patients with 76 cases classified as HFPEF group and NT-pro BNP levels for(2212.01 ± 964.18) pg / ml; left ventricular ejection fraction(LVEF) < 45% patients with 42 cases c lassified as hfref group and NT-pro BNP levels for(9560.12 ± 4275.11) pg / ml, group between NT pro BNP comparison with statistical significance(P < 0.05). Correlation analysis showed that the plasma NT-pro BNP value was significantly negatively correlated with LVEF(r=-0.475, P < 0.01), and the plasma level of NT-pro BNP increased with the decrease of LVEF value.2. According to the 6 months of the occurrence of MACE events, the heart failure patients were divided into group event and non event group. The non event group(93 cases) and the treatment before and after the plasma NT pro BNP concentration respectively(3242.89 ±1534.71) pg / ml and(1173.37± 541.78)pg / ml; event group 25 cases, the treatment before and after the plasma NT pro BNP concentration respectively(12350.72 ± 4881.42) pg / ml and( 5874.17 ± 2932.50) pg / ml. Respectively, the set of event and non event group of patients before and after treatment of NT pro BNP levels were compared, the differences were statistically significant(P < 0.05). Non event group of NT pro BNP in patients with treatment of decline was 62.37%, event group of NT pro BNP in patients with treatment of decline was 48.34%, between the two groups of NT pro BNP before and after treatment decreased compared with the presence of statistically significant difference(P < 0.05). Before and after treatment, the plasma level of NT pro BNP decreased the incidence of mace events of small probability amplitude and decreased significantly in patients with is and treatment of plasma NT pro BNP levels before and after a small decline, falling is not obvious in patients with mace, the probability of large.3. Heart function in I, II, III, IV patients blood uric acid level were(241.65 ± 45.05) umol / L,(349.06± 68.12) umol / L,(436.45 ± 87.13) umol / L,(515.44± 133.78) umol / L, the between group comparison difference has statistical significance(P < 0.05). The higher classification of the heart function, blood uric acid value is higher, assumes the trend of escalation.4.Heart function grade I patients BUN(5.45±1.25 mmol / L, Cr(66.95±18.16) umol / L; grade II BUN(6.81±2.16) mmol / L, Cr(85.94±21.17) umol / L; grade III BUN(9.42±3.58) mmol / L, Cr(97.73± 30.69) umol / L; grade IV BUN(11.39±4.04) mmol / L, Cr(117.16±55.99) umol / L, among the groups of patients with renal function differences in the level of is significant(P < 0.05).The higher the heart function classification, the higher the renal function index, the upward trend.Conclusions: 1. Chronic plasma NT-pro BNP levels and severity of heart failure in patients with heart failure is closely related with the increase of their NYHA class rather elevated; plasma NT-pro BNP levels with the decline in LVEF value rises, negatively correlated with LVEF.2. After medical standard treatment, plasma N T-pro BNP levels in patients with heart failure during hospitalization were significantly decreased within 6 months of adverse cardiovascular events(MAC E) were higher than those of plasma N T-pro BNP levels were no significant decline in plasma NT-pro BNP levels can as a predictor of prognosis in patients with heart failure.3. Serum uric acid levels in patients with chronic heart failure deterioration of cardiac function and gradually increased as the severity of heart failure evaluation index.4. Renal and cardiac function in patients with chronic heart failure associated with the deterioration of heart function, renal function gradually increased. |
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