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目的：通过探讨心脏瓣膜病患者围手术期血浆脑钠肽（BNP）水平的表达与心功能的关系，为相关治疗提供参考。方法：选择 2014 年10 月~2015 年10 月本院收治的心脏瓣膜病患者共50 例，分别于术前1 d、术后6 h、24 h、48 h和术后7 d测量患者血浆 BNP水平，并观测患者左心射血分数（LVEF）、心功能分级、术后呼吸机辅助时间以及住院期间并发症发生情况。结果：术前不同心功能分级患者血浆BNP 水平的总体差异有统计学意义(F=45.767，P<0.05)，心功能分级越高，血浆BNP 水平越高；心脏功能IV 级患者血浆BNP 水平高于III级，III级患者血浆BNP水平高于II级(P<0.05)。术后LVEF<50%和LVEF≥ 50%患者，术前1 d血浆BNP水平分别为（724.21± 132.16）pg/mL和（428.64± 149.31）pg/mL，差异有统计学意义（t=6.628，P<0.001）。不同时间点患者血浆BNP 水平的总体差异有统计学意义（F=29.003，P<0.001）。与术前比较，术后24 h、术后48 h和术后7 d时血浆BNP 水平均显著升高（P<0.05）；术后48h 时BNP 浓度最高，随后开始下降。术后呼吸机辅助使用时间<24 h和≥ 24 h的患者，术前1 d血浆 BNP水平的差异有统计学意义（t=2.378，P=0.021）。结论：心脏瓣膜病患者围手术期血浆BNP 水平的变化能够准确的反映患者心功能情况，对患者术前病情评估和术后临床处理具有一定的指导意义。`

英文摘要:

Objective:To explore the relationship of plasma BNP level expression and cardiac function levels of patients with valvular heart disease in perioperative period, and provide evidence for clinical therapy.Methods:Selected 50 cases of patients with valvular heart disease in our hospital from October 2014 to October 2015, detected the plasma BNP level expression at 1d before operation, 6 h, 24 h, 48 h and 7 d after operation were measured,and observed the indexes of left ventricular ejection fraction (LVEF), cardiac functional levels, ventilator assisted time and complications during hospitalization.Results:The differences of plasma BNP level expression in cardiac function levels were statistically significant(F=45.767, P<0.05), the higher the cardiac functional levels, the higher the level of plasma BNP level; The plasma BNP level in patients with IV cardiac functional levels were higher than that of III, and plasma BNP level in patients with level III cardiac functional levels was higher than that of II (P<0.05). In patients with LVEF<50%and LVEF≥ 50% after operation, the plasma BNP level expression were (724.21± 132.16)pg/ml and (428.64± 149.31)pg/mL, the differences were statistically significant(t=6.628, P<0.001). The overall difference of plasma BNP level at different time points in patients was statistically significant (F=29.003, P<0.001). Compared with before operation, the BNP plasma levels of patients were significantly increased at 24 h, 48 h and 7 d after operation(P<0.05); The highest expression of plasma BNP level was at 48 h after operation, and then began to decreased. In patients with ventilator assisted time <24 h and ≥ 24 h after operation, the difference of plasma BNP level at 1d after operation was statistically significant(t=2.378, P=0.021).Conclusion:The changes of plasma BNP levels of patients with valvular heart disease in perioperative period is able to accurately reflect the cardiac function of patients,and with guiding significance for preoperative assessment and postoperative clinical management.

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