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Objective: To observe the mitral valve replacement in patients with perioperative brain natriuretic peptide (brain natriuretic peptide, BNP), N-terminal pro brain natriuretic peptide (N-terminal proBNP, NT-proBNP) and the ratio (NT-proBNP/BNP) changes in laws, and its clinical significance. Methods: 25 cases of mitral stenosis (MS group) and 20 patients with mitral regurgitation (MR group) patients, preoperative cardiac function according to standard criteria NYHA classification, respectively, 1 day before surgery, after 1 week, two weeks, three weeks, four weeks measured plasma BNP, NT-proBNP concentrations are simultaneously echocardiography, measurement of left ventricular ejection fraction (LVEF), left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDD ), analysis of preoperative BNP, NT-proBNP, NT-proBNP/BNP concentration and NYHA class, LVEF, LAD, LVEDD other relationships and compare them with the MS group in the MR group changes its perioperative and intraoperative Complications after the relationship. Results: ① MS preoperative BNP, NT-proBNP and NYHA, LVEDD were positively correlated (P lt; 0.05), and LVEF, LAD no correlation (P gt; 0.05), and the BNP and NYHA, LVEDD correlation than NT -proBNP, NT-proBNP/BNP strong; ② postoperative complications in patients with atrial fibrillation preoperative BNP, NT-proBNP above does not appear in patients with atrial fibrillation and atrial cardioversion with decreased; postoperative renal function insufficiency in patients whose preoperative NT-proBNP than those without renal insufficiency patients is high, and with the recovery of renal function and decreased; while NT-proBNP/BNP no such changes; ③ preoperative MR group LVEDD, BNP, NT-proBNP were higher than the MS group, and with LVEDD change, BNP, NT-proBNP between the two groups no significant difference becomes rather NT-proBNP/BNP before surgery between the two groups was not statistically significant; ④ mitral Perioperative BNP, NT-proBNP increased first and then decreased trend, and BNP, NT-proBNP, LVEDD broadly consistent trend, mainly 1,2,3 weeks after surgery, while NT-proBNP/BNP Changes and BNP, NT-proBNP and LVEDD no obvious regularity linked. Conclusion: ① BNP in patients with mitral valve disease as preoperative evaluation of cardiac function reference index; ② BNP, NT-proBNP, LVEDD measured for evaluation and prediction of postoperative atrial fibrillation may be more clinical value, and NT-proBNP is renal insufficiency assess, predict a good indicator; ③ perioperative MR group and the MS group BNP, NT-proBNP and LVEDD differences may be mainly related to the size; ④ mitral valve disease perioperative monitoring LVEDD simultaneous determination of BNP, NT-proBNP has a positive The clinical significance.
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