Clinical Significance of BNP and Cardiac Function Changes for Diabetic Nephropathy with Heart Failure
Objective To explore the clinical significance of plasma B-type natriuretic peptide (BNP) expression levels and changes in cardiac structure and function for patients with diabetic nephropathy complicated with chronic heart failure. Methods The paper chose 62 patients with type Ⅱ diabetes nephropathy complicated with chronic heart failure in our hospital from December 2020 to December 2021 as the observation group,and 40 patients with type Ⅱ diabetes at the same time as the control group,and divided them into grade I of 16 cases,grade Ⅱ of 14 cases,grade Ⅲ of 20 cases,and grade Ⅳ of 12 cases according to the New York Heart Association (NYHA) cardiac function classification standard. The paper analyzed clinical data of all patients retrospectively,detected the BNP level,and drawn receiver operating characteristic (ROC) curve to analyze their diagnostic value and prognostic effect,measured and recorded major parameters with cardiac color Doppler ultrasound,including left ventricular end systolic diameter (LVEDs),left ventricular end diastolic diameter (LVEDd),and left ventricular ejection fraction (LVEF). The levels of BNP with clinical NYHA functional grading and left ventricular ejection fraction were compared in each group. The correlation between BNP levels and NYHA cardiac function grading was analyzed with statistical methods of Spearman rank correlation analysis. The sensitivity and specificity was calculated through ROC curve. Results The BNP detection levels in the observation group were higher than the control group,difference was statistically significant (P<0.01). The BNP level increased with the increase of cardiac function grading,and there was statistically significant difference between different grades of grade Ⅱ,Ⅲ,and Ⅳ,(P<0.05). Spearman rank correlation analysis showed a positive correlation (P<0.05). BNP was positively correlated with LVEDD and LVEDS (P<0.05),and negatively correlated with LVEF (P<0.05). The ROC curve analysis showed the optimal cutoff value for BNP was 128 pg/mL as a reference indicator for heart failure diagnosis,with sensitivity of 91.32％ and specificity of 77.29％. Conclusion BNP has significant correlation with cardiac structure and function of patients with diabetic nephropathy and chronic heart failure,and can be used as sensitive index for diagnosis,disease detection and evaluation of cardiac function. BNP has good correlation with LVEDD,LVEDS,and LVEF of patients with heart failure,which is a good indicator of left heart function and cardiac remodeling.
万方数据
维普
