ObjectiveTo investigate the effect of the levels of serum lipid on the prognosis of patients with severe heart failure.MethodsThe clinical data of 149 patients with severe heart failure was analyzed retrospectively,the levels of serun lipid were compared among different causes and different NYHA cardiac functional grading patients.And the prognosis was compared between low-serum lipid and non-low-serum lipid patients.Results There were significant differences in the levels of total cholesterol(TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),albumin (ALB) among different NYHA cardiac functional grading (P ＜0.05),but there was no significant difference in triacylglycerol (TG) among different NYHA cardiac functional grading(P ＞ 0.05 ).The levels of TC,HDL-C,LDL-C in dilated cardiomyopathy and rheumatic heart disease were lower than those in coronary heart disease combined with hypertension and ischemic cardiomyopathy,there were significant differences (P ＜0.05).Followed up for 2 years,the mortality,deteriorated frequency,hospitalization frequency more than 2 times a year and hospitalization time more than 1 month in low-serum lipid patients [29.0％ (9/31 ),25.8％ ( 8/31 ),48.4％ ( 15/31 ),61.3％ ( 19/31)]were higher than those in non-low-serum lipid patients [9.3 ％ ( 11/118 ),9.3％ ( 11/118 ),17.8％ (21/118 ),24.6％ (29/118 )],and there were significant differences (P ＜ 0.01 or ＜0.05).Conclusions For patients with severe heart failure,NYHA cardiac functional grading has significantly negative correlation with their serum lipid levels.Lower serum lipid levels will seriously affect the prognosis of patients.

Objective To explore the efficacy of recombinant human brain natriuretic peptide (rhBNP) in the treatment of heart failure patients with coronary heart disease (CHD).Methods Ninety-six CHD patients with heart failure were divided into observation group (48 cases) and control group (48 cases) by random digits table,and rhBNP was used in observation group and nitroglycerin was used in control group.The efficacy,left ventricular ejection fraction (LVEF) and urine output in two groups were observed.Results The total effective rate in observation group was 93.75％ (45/48),and 81.25％ (39/48) in control group,there was significant difference between two groups (P ＜ 0.05).LVEF and urine output after treatment were better than those before treatment [observation group:(57.7 ± 3.9)％ vs. (32.5 ± 3.1 )％,(70.5 ± 31.1 ) ml/h vs.(34.5 ± 13.7) ml/h;control group:(52.2 ± 3.3)％ vs.(33.4 ± 2.9)％,(53.6 ± 23.4) ml/h vs.(33.8 ± 13.4)ml/h,P ＜ 0.05 ].After treatment,LVEF and urine output in observation group were higher than those in control group (P ＜ 0.05 ).Incidence of adverse reaction in observation group was lower than that in control group [ 18.75％ (9/48) vs.35.42％ ( 17/48),P ＜ 0.05 ].Conclusion rhBNP has curative effect and small adverse reactions on CHD patients with heart failure,and can significantly improve the patients' general condition.