摘要
目的:探讨联合检测NT-pro BNP(氨基末端B型钠尿肽原)、H-FABP(心型脂肪酸结合蛋白)和cTnI(心肌肌钙蛋白Ⅰ)对老年重症心力衰竭患者的临床价值。方法:选取2013年6月-2014年12月于本院心内科就诊的老年重症心力衰竭患者302例作为研究组,根据患者随访期内心脏不良事件的发生情况分为两组,无不良事件组,患者113例;心脏不良事件发生组中再入院患者107例,死亡患者82例。选取同时期老年非重症心力衰竭患者80例,作为对照组1,选取同期本院健康体检者80例,作为对照组2。在刚入院时及治疗1、2、4、8周后抽取所有受试者空腹静脉血2.5 m L,用免疫层析法检测其血清NT-pro BNP、H-FABP和cTnI。结果:研究组入院时NT-pro BNP、H-FABP和cTnI的水平均显著高于对照组1和对照组2;对照组1入院时NT-pro BNP水平显著高于对照组2,比较差异均有统计学意义(P<0.05),两组H-FABP和cTnI水平比较差异均无统计学意义(P>0.05)。血清NT-pro BNP、H-FABP的AUC、敏感性均显著高于血清cTnI,特异性低于血清cTnI,联合检测的敏感性显著高于血清NT-pro BNP、H-FABP和cTnI单项检测的敏感性,比较差异均有统计学意义(P<0.05)。治疗前,心脏不良事件发生组血清NT-por BNP水平明显高于无不良事件组,死亡组血清H-FABP水平明显高于其余两组,比较差异均有统计学意义(P<0.05),不同预后组血清cTnI水平比较,差异无统计学意义(P>0.05)。治疗后第1周,无不良事件组血清NT-pro BNP、H-FABP和cTnI均显著降低,治疗后第2、4、8周继续下降,与治疗前比较差异均有统计学意义(P<0.05)。再入院组治疗后第2周血清NT-pro BNP、H-FABP和cTnI显著降低,与治疗前比较差异均有统计学意义(P<0.05),治疗后第4周和第8周未观察到下降。在治疗过程中,死亡组血清NT-pro BNP、H-FABP和cTnI持续升高,治疗后第1周和第8周3项指标水平均高于治疗前,比较差异均有统计学意义(P<0.05)。结论:血�
Objective： To investigate the clinical value of combined detection of NT-proBNP （ N-terminal pro-B-type natriuretic peptide ）,h-FABP （ heart type fatty acid binding protein ） and cTn I （ myocardial troponin I ） in elderly patients with severe heart failure.Method： Three hundred and two dderly patients with severe heart failure from June 2013 to December 2014 admitted to our hospital were considered as the study group and were divided into two groups according to their adverse cardiac events during the follow-up period, no adverse events group, with 113 patients in this group; adverse cardiac events group, with 107 readmission patients and 82 death patients.In the same period, 80 patients with non-severe heart failure were selected as the control group 1 and 80 cases of healthy persons were selected as the control group 2.The NT-proBNP, H-FABP and cTn I of all groups were counted by immunochromatographic method before and 1 week, 2, 4, 8 weeks after treatment.Result： Before treatment, the NT-proBNP, H-FABP and cTn I levels of patients in the study group were significantly higher than those of the control group 1 and control group 2, the NT-proBNP level of the control group 1 was significantly higher than that of the control group 2, the differences were statistically significant （ P〈0.05 ）, the differences of H-FABP and cTn I levels between the control group 1 and the control group 2 had no statistical signgificance （ P〉0.05 ） .The sensitivity and AUC of serum NT-proBNP and H-FABP were significantly higher than those of serum cTn I, their specificity was lower than serum cTn I; the sensible of combined detectionwas significantly higher than that of other indexes, the differences were statistically significant （ P〈0.05 ） .Before treatment, the serum NT-porBNP level of the adverse cardiac events group was significantly higher than that of no adverse events group, the level of serum H-FABP of the death group was significantly higher than that of the other two groups, the difference
出处
《中国医学创新》
CAS
2016年第10期15-19,共5页
Medical Innovation of China
