| Objective:To investigate the serum level of BNP(brain natriuretic peptide)in patients with congestive heart failure caused by different heart diseases with grade IV cardiac function,and to assess the significance of BNP in the diagnosis and prognosis evaluation of heart failure caused by different causes.Methods:1.The object of study: we collected 297 cases of patients who diagnosed chronic heart failure by different causes that according to the symptoms,signs and echocardiography examination from June 2014 to January 2016,the cardiac function class of patients were class IV according to the New York Heart Association classification.There were 150 cases of male and 147 cases of female,aged(66.8±12.4)years old,divided into six groups according to the etiology of heart failure,including 51 cases of coronary atherosclerotic heart disease group,50 cases of hypertensive heart disease group,rheumatic heart disease group of 41 cases,non rheumatic heart disease group of 56 cases,dilated cardiomyopathy group of 52 cases,pulmonary heart disease group of 47 cases.There was no significant difference in age,sex,smoking history,blood lipid abnormality and blood pressure among the groups(P>0.05).Exclusion criteria:(1)acute heart failure;(2)The glomerular filtration rate was less than 60mL/min,and combined with serious renal function(serum creatinine,250gmol/L);(3)The underlying causes of heart failure were more than one;(4)Valvular disease of the three tricuspid valve and pulmonary valve;(5)The obstructive hypertrophic cardiomyopathy;(6)The thyroid dysfunction;(7)The serious infection;(8)After cardiopulmonary resuscitation;(9)Combined with hematological diseases;(10)Malignant tumor.2.Diagnostic criteria: According to the ESC Guidelines for the diagnosis and treatment of heart failure 2012.3.The serum BNP detection: There were 297 patients who admitted to the hospital before treatment,the blood samples were taken 3ml from the median cubital vein,and the blood samples were determined by EDTA.4.Statistical analysis methods: The data are processed by SPSS19.0 statistical software,and the data of normal distribution or approximately normal distribution are represented by (?)±s.The BNP data of each group were compared with the complete random design data analysis of variance.If the overall difference between the groups was statistically significant,the LSD method was used to compare between any two groups of the mean.Enumeration data were checked by chi square.The difference was statistically significant less than 0.05.Result:Coronary heart disease group,hypertensive heart disease group,rheumatic heart disease group,non rheumatic valvular heart disease group,dilated cardiomyopathy group,pulmonary heart disease group,the serum levels of BNP in patients were(1513.9±1125.5)pg/mL,(1087.9±812.0)pg/mL,(636.0±821.0)pg/mL,(1171.8±935.6)pg/mL,(1462.4±988.6)pg/mL,(641.4±610.9)pg/mL.There was significant difference of the serum level of BNP in patients with congestive heart failure caused by different heart diseases with grade IV cardiac function(P < 0.001),among them,the serum level of BNP in coronary atherosclerotic heart disease group,dilated cardiomyopathy group,hypertensive heart disease group,non rheumatic valvular heart disease group were higher than that of rheumatic heart disease group and pulmonary heart disease group(P < 0.05);there was no significant difference of the level of BNP between the rheumatic heart disease group and pulmonary heart disease group(P > 0.05);the serum level of BNP in coronary atherosclerotic heart disease group and dilated cardiomyopathy group were higher than that in hypertensive heart disease group and non rheumatic valvular heart disease group(P < 0.05);there was no significant difference of the level of BNP between the hypertensive heart disease group and non rheumatic valvular heart disease group(P > 0.05);there was no significant difference of the level of BNP between the coronary atherosclerotic heart disease group and dilated cardiomyopathy group(P >0.05).Conclusion:Different serum levels of BNP in patients with congestive heart failure with different underlying causes,the serum levels of BNP in dilated cardiomyopathy group and coronary heart disease group were the highest,and the serum levels of BNP in the hypertensive heart disease group and non rheumatic valvular heart disease group were higher,the serum levels of BNP in the rheumatic heart disease group and pulmonary heart disease group were the lowest.Therefore,BNP should be considered as a marker for the diagnosis of heart failure,assessment of the condition and prognosis. |
PDF Full Text Request