目的 探究糖化血红蛋白(HbA1c)和B型尿钠肽(BNP)检测在糖尿病合并慢性心力衰竭患者中的临床意义.方法 选择2015年5月至2016年5月收治的40例2型糖尿病合并慢性心力衰竭患者作为观察组,另选取同期收治的40例2型糖尿病患者作为对照组.观察对比两组HbA1c、BNP水平,并记录观察组不同心功能患者的HbA1c、BNP水平变化.结果 观察组的HbA1c和BNP检测水平均高于对照组(P<0.01);观察组患者随着心功能越来越差,HbA1c、BNP水平逐渐增高,且呈同步增高,Ⅱ级、III级、Ⅳ级患者相关指标比较差异有统计学意义(P<0.01).随访6个月,观察组主要心脏不良事件发生率为42.5%,高于对照组的22.5%(χ2=6.651,P<0.05);经单因素直线分析,HbA1c、BNP与主要心脏不良事件发生率的呈正相关,分别为(R=0.075,P=0.024)、(R=0.084,P=0.013).结论 监测H b A 1 c、B N P水平对糖尿病合并慢性心力衰竭患者的病情诊断、预后评估有重要的参考价值.%Objective To explore the clinical significance of glycosylated hemoglobin (HbA1c)and B type urinary sodium peptide (BNP)in diabetic patients with chronic heart failure. Methods A total of 40 patients with type 2 diabetes mellitus and chronic heart failure in this hospital during May 2015 to May 2016 were allocated in observation group,and other 40 patients with type 2 diabetes mellitus treated in this hospital at the same period were listed as control group,and their blood levels of HbA1c and BNP were examined and patients with different degree of cardiac function and changes in levels of HbA1c and BNP were recorded and compared. Results The blood levels of HbA1c and BNP in pa-tients of observation group were higher than those of patients in control group (P < 0. 01),and the levels of HbAlc and NBNP in patients of obser-vation group were gradually incresed following the worsening of cardiac function,and the degree of increase in levels of HbA1c and BNP was syn-chronized with the worsening of their cardiac function,and the difference in relative indicators of patients with heart function at Ⅱ,III or Ⅳ level was statistically significant (P < 0. 01). The incidence of major adverse cardiac events in patients of observation group in follow-up period of 6 months was 42. 5%,and it was higher than that (22. 5%)of patients in control group (χ2 = 6. 651,P < 0. 05). By the single factor linear analy-sis,blood levels of HbA1c and BNP were positively correlated with the incidence of major adverse cardiac events (R = 0. 075,P = 0. 024),(R= 0. 084,P = 0. 084). Conclusion The monitoring of HbA1c and BNP in diabetic patients complicated with chronic heart failure has important reference value in their diagnosis and assessment of prognosis.
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