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目的：研究冠状动脉旁路移植手术后患者B 型脑钠钛（BNP）水平变化规律及临床意义。方法：选取我院2014 年6 月到2015 年6 月间收治的冠状动脉旁路移植手术患者80 名，根据患者心脏左心室射血分数（LVEF）分为A 组（>45%）和B组（≤ 45%），观察两组患者在不同时间的BNP水平，对比两患临床相关指标、及心房颤抖和心功能不全发生情况。结果：A 组患者在血管活性物质使用量、呼吸机使用时间、监护室停留时间及心房颤抖和心功能不全发生率都明显小于B 组，差异有统计学意义（P＜0.05）；术后6h 两组患者的BNP 水平开始明显上升，在术后24h 达到峰值，此后开始下降但仍维持较高水平，组内比较差异均有统计学意义（P<0.05）。A 组患者在术前及术后各个时间段内BNP 水平均明显小于B 组，组间比较比较均有统计学意义（P＜0.05）。结论：冠状动脉旁路移植患者围手术期BNP 水平可以反应患者心脏功能状况，BNP水平越高表示患者心脏越差。

英文摘要:

Objective:To study the changes of perioperative BNP level in patients with coronary artery bypass graft and its clinical significance.Methods:A total of 80 patients undergoing coronary artery bypass graft surgery, who were admitted to First Affiliated Hospital of Xinjiang Medical University fromJune 2014 to June 2015, were selected and divided into groupA (>45%) and group B (≤ 45%) according to theleft ventricular ejection fraction (LVEF). The BNP levels of the two groups at the different time were observed; the clinical related indicators, occurring rate of atrial fibrillation and cardiac insufficiency between two groups were compared.Results:Usage of casoactive substances, ventilator time, time to stay in ICU, occurring rates of atrial fibrillation and cardiac insufficiency of group A were significantly less than those of groupB (P<0.05), the difference was statistically significant（P＜0.05）. The levels of BNP in the two groups 6 h after operation began to increase significantly, reaching to the peak 24 h after operation, then began to decrease but remained at a high level, the difference was statistically significant (P<0.05). The levels of BNP in groupA were significantly lower than those in group B before and after operation, and the comparison between groups was statistically significant (P<0.05).Conclusion:The BNP levels in the perioperative period of the patients undergoing coronary artery bypass grafting can reflect the cardiac function: the higher the BNP levels, the worse the function of the heart.

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