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目的：探讨血浆脑钠肽（BNP）监测对慢性心力衰竭（CHF）患者治疗的指导价值及其对预后的影响。方法：根据出院后是否进行BNP 监测，将2009 年5 月至2010 年12 月我院心内科出院的CHF 患者100 例随机分为监测组和对照组，每组各50 例。平均随访时间为1 年，观察两组的治疗效果和预后包括心血管性死亡、因心血管事件再次住院例数、NYHA 心功能分级、明尼苏达心衰生活质量问卷（MLHFQ）评分。结果：随访1 年期间，监测组心血管性死亡率、因心血管事件再次住院率分别为2%、18.0%，对照组分别为16.0%、54.0%，差异均有统计学意义(P<0.05)。出院时与第1 次随访，两组患者明尼苏达心衰生活质量问卷评分结果比较差异无统计学意义(P>0.05)；而第2、3、4 次随访时，监测组试验结果均显著高于对照组，差异有统计学意义(P<0.05)。随访1 年时，监测组患者的NYHA 心功能分级、抗心衰药物的靶剂量率显著优于对照组，差异有统计学意义(P<0.05)。结论：通过血浆BNP 水平监测，及时调整治疗方案，可延缓心衰的进展，改善患者预后。

英文摘要:

Objective: To explore the guidance value and prognostic influence of serum brain natriuretic peptide (BNP) monitoring in patients with chronic heart failure(CHF). Methods: According to whether having BNP monitoring or not, 100 cases of CHF were divided into two groups, including 50 cases of monitoring group and 50 cases of control group. All the patients were followed-up for 1 year on average, the effect and prognosis including cardiac death, cases of cardiac readmission, NYHA heart function classification and MLHFQ were observed and analyzed. Results: During the 1 year follow-up, the rates of death and cardiac readmission in monitoring group (2%, 18.0%) were significantly lower that in control group(16.0%, 54.0%)(P<0.05). At discharge and first time follow-up, there were no significant difference on MLHFQ between the two groups (P<0.05), but the result of MLHFQ was significant higher in monitoring group than that in control group at second, third and fourth time follow-up (P<0.05). The NYHA heart function classification and rate of patients receiving target dosage of drugs in monitoring group was better than that in control group at fourth time follow-up, the difference was statistically significant (P<0.05). Conclusions: Adjusting the treatment timely by serum BNP monitoring can contribute to slow the development of CHF and improve the prognosis.

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