摘要
目的:探讨血浆N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-pro BNP)水平评估心力衰竭(heart failure,HF)患者预后的价值。方法:选择2012年6月至2014年7月本院住院的心衰患者96例,在入院第二天常规行心脏彩超及血液生化检查,并测定患者血浆中NT-pro BNP水平。对患者的一般资料、心脏彩超、NT-pro BNP水平及18个月随访期内心脏不良事件发生率进行分析。按随访期内是否发生心脏不良事件分为事件组与非事件组,根据NT-pro BNP水平高低分为高NT-pro BNP组(NT-pro BNP>3200 pg/m L)和低NT-pro BNP组(NT-pro BNP≤3200 pg/m L),并对相关数据进行统计学分析。结果:事件组NT-pro BNP水平较非事件组明显增高(P<0.001)。多因素logistic回归分析显示只有NT-pro BNP是预测心脏不良事件发生的独立危险因素。NT-pro BNP水平预测心衰患者18个月内死亡的ROC曲线下面积为0.873,以随访患者平均NT-pro BNP水平均数3200pg/m L作为分组的界值,通过Kaplan-Meier法作NT-pro BNP不同水平患者在随访期间心脏不良事件发生率曲线,计算Log-rank为29.563(P=0.000)。结论:血浆NT-pro BNP水平是心衰患者发生心脏不良事件的独立危险因素之一,不同NT-pro BNP水平对心衰患者的预后影响不同,超过3200 pg/m L的患者预后较差。
Objective： To explore the prognostic value of plasma NT-proBNPin patients with heart failure. Methods： Totally 96 patients with heart failure were enrolled in the study. Color echocardiography and blood biochemical examination were performed at sec- ond day after admission. Plasma NT-proBNP of patients was measured.The general data, color echocardiography, NT-proBNP and the incidence of adverse cardiac events during 18 months of follow up were analyzed.According to the incidence of adverse cardiac events during the follow up, all patients were divided into event group and non-event group.According to the level of NT-proBNP, all patients were divided into high NT-proBNPgroup （NT-proBNP〉3200 pg/mL） and low NT-proBNPgroup （NT-proBNP≤ 3200 pg/mL）. The data was analyzed by statistics. Results： Compared with non-event group, NT-proBNP level in event group was increased obviously（P〈0.001）. Multiple logistic regression analysis showed that only NT-proBNPwas an independent risk factor for adverse cardiac events. The area un- der ROC curve for predicting cardiac death of heart failure patient within 18 months by NT-proBNPwas 0.873. The mean NT-proBN- Pwith 3200 pg/mL in patients during follow up was taken as the value for the grouping, then the curve of the incidence of adverse cardiac events of patients with different level of NT-proBNPduring follow up was made by using Kaplan-Meier method, and Log-rank calculated was 29.563 （P =0.0000）. Conclusions： NT-proBNP level is an independent risk factor of adverse cardiac events in patients with heart fail- ure. The influence of different level of NT-proBNP on the prognosis of patients with heart failure is different. Patients with NT-proBNP- 3200pg/mL have poor prognosis.
出处
《现代生物医学进展》
CAS
2015年第21期4098-4101,共4页
Progress in Modern Biomedicine
基金
上海市卫生局基金项目(20124Y103)
同济大学附属杨浦医院基金项目(SE1201214)
