本文選題：吸煙 + 慢性心力衰竭��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:本研究擬探討吸煙與慢性心力衰竭患者血漿N末端B型腦鈉肽(NT-pro BNP)水平的相關(guān)性,以及其他臨床因素與血漿NT-pro BNP水平的關(guān)系。方法:收集山西省人民醫(yī)院心內(nèi)科二病區(qū)住院的113例慢性心力衰竭患者,記錄研究對象的年齡、性別、體重指數(shù)(BMI)、收縮壓(SBP)、舒張壓(DBP)、心功能級別、基礎(chǔ)疾病史、吸煙和飲酒狀況等一般項目以及檢測空腹血糖(FPG)、總膽固醇(TC)、甘油三酯(TG)、高密度脂蛋白膽固醇(HDL-c)、低密度脂蛋白膽固醇(LDL-c)、丙氨酸氨基轉(zhuǎn)移酶(ALT)、天冬氨酸氨基轉(zhuǎn)移酶(AST)、血肌酐(Scr)、血尿素氮(BUN)、血紅蛋白(Hb)、NT-pro BNP等生化指標(biāo)。按照吸煙狀況將研究對象分為吸煙組、戒煙組以及非吸煙組,對三組間一般項目及生化指標(biāo)進(jìn)行比較,采用多元線性回歸分析年齡、性別、吸煙狀況、飲酒狀況、BMI、FPG、TG、TC、HDL-c、LDL-c、SBP、DBP、心功能級別、基礎(chǔ)疾病史與血漿NT-pro BNP水平的關(guān)系。結(jié)果:(1)以吸煙組、戒煙組、非吸煙組為不同暴露組,三組在血漿NT-pro BNP的表達(dá)水平上,差異顯著,具有統(tǒng)計學(xué)意義(P0.05),且經(jīng)兩兩比較差異均有統(tǒng)計學(xué)意義(P0.05),吸煙組NT-pro BNP水平較戒煙組和非吸煙組顯著升高,且戒煙組高于非吸煙組。比較三組患者BMI、HDL-c、ALT、AST、Scr、BUN、WBC、Hb、Plt、SBP、DBP、心功能級別,差異無統(tǒng)計學(xué)意義(P0.05),但比較年齡、性別、FPG、TC、TG、LDL-c,三組差異有統(tǒng)計學(xué)意義(P0.05),且經(jīng)兩兩比較,差異均有統(tǒng)計學(xué)意義(P0.05)。(2)以年齡、性別、吸煙狀況、飲酒狀況、BMI、FPG、TG、TC、HDL-c、LDL-c、SBP、DBP、心功能級別、基礎(chǔ)疾病史作為自變量,血漿NT-pro BNP水平作為因變量,進(jìn)行多元線性回歸分析,結(jié)果顯示與血漿NT-pro BNP水平相關(guān)的因素為吸煙狀況、年齡、心肌病(P0.05)。結(jié)論:(1)吸煙是引起血漿NT-pro BNP水平升高的重要危險因素。(2)吸煙組患者較非吸煙組患者心衰發(fā)病年齡平均提前15年。(3)與NT-pro BNP水平相關(guān)的其他因素為年齡、心肌病。(4)NT-pro BNP水平隨年齡增加而升高,但吸煙組患者年齡較戒煙組及非吸煙組偏低,而NT-pro BNP水平反而偏高,很可能吸煙加重心衰嚴(yán)重程度。
[Abstract]:Aim: to investigate the relationship between smoking and plasma N-terminal B-type brain natriuretic peptide (NT-pro) BNPs in patients with chronic heart failure, and the relationship between other clinical factors and plasma NT-pro BNP levels. Methods: 113 patients with chronic heart failure (CHF) in the second ward of cardiology of Shanxi Provincial people's Hospital were collected. The subjects' age, sex, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiac function grade, history of basic diseases were recorded. General items, such as smoking and drinking status, and the detection of fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-c), alanine aminotransferase (alt), aspartate aminotransferase (AST), etc. Serum creatinine (SCR), blood urea nitrogen (bun), hemoglobin (HB) and NT-pro BNP, etc. According to the smoking status, the subjects were divided into smoking group, smoking cessation group and non-smoking group. The general items and biochemical indexes were compared among the three groups. Age, sex, smoking status and drinking status were analyzed by multiple linear regression analysis. The relationship between the history of basic diseases and plasma NT-pro BNP level. Results (1) there were significant differences in plasma NT-pro BNP expression among smoking group, smoking cessation group and non-smoking group. The NT-pro BNP level of smoking group was significantly higher than that of smoking cessation group and non-smoking group, and the level of NT-pro BNP in smoking group was higher than that in non-smoking group. There was no significant difference in heart function grade, but age, sex, TGG, LDL-c, and the difference between the three groups were statistically significant (P 0.05), and the difference was significant in age, sex, smoking status, and the difference was significant in two groups (P < 0.05), but the difference was significant in age, sex, smoking status, age, sex, TGN, LDL-c, and the difference between the three groups was statistically significant (P0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05). Alcohol consumption status was determined by multivariate linear regression analysis. The results showed that smoking status, age, cardiomyopathy P0.05 were the main factors related to the drinking status of BMI-FPGG, HDL-cCU LDL-cU, cardiac function, history of basic disease as independent variable, plasma NT-pro BNP level as dependent variable. The results showed that the factors related to plasma NT-pro BNP level were smoking status, age, and cardiomyopathy P0.05. the results showed that the risk factors associated with NT-pro BNP level were smoking status, age, and cardiomyopathy P0.05. Conclusion smoking is an important risk factor for the increase of plasma NT-pro BNP level. (2) the mean age of onset of heart failure in smoking group is 15 years earlier than that in non-smoking group. Other factors associated with NT-pro BNP level are age. The level of NT-pro BNP in cardiomyopathy increased with the increase of age, but the age of smoking group was lower than that of smoking cessation group and non-smoking group, but the level of NT-pro BNP was higher than that of non-smoking group, which may aggravate the severity of heart failure by smoking.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 蘇華;陳琛;李寶亮;;B-型鈉尿肽和N-末端B-型鈉尿肽前體在疾病診斷和預(yù)后判斷中應(yīng)用價值[J];中國老年學(xué)雜志;2016年22期

2 金鵬;;老年充血性心力衰竭治療后NT-proBNP不同水平患者預(yù)后情況分析[J];中國實用醫(yī)藥;2016年29期

3 楊倩紅;陸有為;陸潔;孫玨;許佳毅;;血漿N端B型鈉尿肽原對老年慢性心力衰竭病情評估及預(yù)后判斷價值的研究[J];中華老年多器官疾病雜志;2016年09期

4 張馨允;楊雪茜;武愛萍;馬超;楊穎慧;;2型糖尿病患者N末端前體B型尿鈉肽水平變化及其影響因素分析[J];中國慢性病預(yù)防與控制;2016年09期

5 羅慧敏;劉紹輝;何明豐;李曠怡;吳智鑫;;血漿NT-proBNP在急性心力衰竭診治及預(yù)后評估中的應(yīng)用價值[J];中華衛(wèi)生應(yīng)急電子雜志;2016年04期

6 黃惠慧;林士云;余湘寧;黃斯斯;鄧家強;趙獻(xiàn)明;;南寧市健康人群N末端B型利鈉肽原水平的影響因素及正常參考范圍的預(yù)測[J];廣西醫(yī)學(xué);2016年07期

7 張美娟;;夜間陣發(fā)性呼吸困難患者N末端B型鈉尿肽原的變化及其影響因素[J];中國實驗診斷學(xué);2016年06期

8 盧偉智;趙武民;古勛清;劉斌;;慢性心力衰竭患者血漿NT-proBNP的變化及臨床意義[J];中華衛(wèi)生應(yīng)急電子雜志;2016年03期

9 鄧榮花;韓清華;;血漿腦鈉肽與慢性心力衰竭嚴(yán)重程度的相關(guān)性分析[J];中西醫(yī)結(jié)合心腦血管病雜志;2016年06期

10 周京敏;崔曉通;葛均波;;中國心力衰竭的流行病學(xué)概況[J];中華心血管病雜志;2015年12期

相關(guān)碩士學(xué)位論文 前2條

1 托麗斯;去脂肪體重指數(shù)對老年慢性心衰患者肌肉含量的評估及分析[D];吉林大學(xué);2016年

2 胡楠;香煙引起的心力衰竭機制及金屬硫蛋白對小鼠心肌的保護(hù)研究[D];河北農(nóng)業(yè)大學(xué);2011年

，

本文編號：1879052