摘要
目的探讨超声联合可溶性ST2、NT-proBNP在射血分数降低型心力衰竭评估中的应用价值。方法随机从2018年3月至2019年6月本院临床初诊为心力衰竭的患者中抽取140例为研究对象,依据超声心动图检查结果,结合钠尿肽水平等,将入选病例分为射血分数降低型心力衰竭(HFrEF组,70例)和射血分数保留型心力衰竭(HFpEF组,70例),采集两组患者入院12 h内静脉血样,测定血清可溶性ST2与NT-proBNP水平,比较观察组间指标差异及指标水平同超声心动图检查结果相关性。随访HFrEF组患者6个月,记录终点事件,观察不同预后患者超声心动图诊断与血清学指标水平,评价诊断灵敏度与特异度。结果HFrEF组LVEF低于HFpEF组,QRS波时限长于HFpEF组,可溶性ST2、NTproBNP高于HFpEF组,差异均有统计学意义(均P<0.05)。相关性分析示,HFrEF患者QRS波时、可溶性ST2、NT-proBNP与LVEF呈负相关(均P<0.05)。HFrEF预后不良患者LVEF低于预后良好者,QRS波时限、可溶性ST2、NT-proBNP高于预后良好者,差异均有统计学意义(均P<0.05),4项指标平行联合预测预后灵敏度最高(92.4%),系列联合预测特异度最高(93.7%)。结论超声联合可溶性ST2、NT-proBNP是诊断鉴别射血分数降低型心力衰竭的可行方法,可以较好地反映病情严重程度,在预测不良预后方面也具有较高的评估价值。
Objective To explore the application value of ultrasound combined with soluble ST2 and NTproBNP in the assessment of heart failure with reduced ejection fraction.Methods A total of 140 patients with clinical diagnosis of heart failure were randomly selected from March 2018 to June 2019 in our hospital.Based on the results of echocardiography combined with natriuretic peptide level,the selected cases were divided into heart failure with reduced ejection fraction(HFrEF group,70 patients)and heart failure with preserved ejection fraction(HFpEF group,70 patients).The fasting venous blood samples were collected from the two groups of patients with 12 h after admission,and serum soluble ST2 and NT-proBNP levels were measured.The differences in indicators between the two groups and their correlation with the results of echocardiography were analyzed.The patients in the HFREF group were followed up for 6 months,the endpoint events were recorded,echocardiographic diagnosis and serological indexes levels of patients with different prognosis were observed,the diagnostic sensitivity and specificity were evaluated.Results The LVEF of the HFrEF group was lower than that of the HFpEF group,the QRS wave duration of the HFrEF group was longer than that of the HFpEF group,and the levels of soluble ST2 and NT-proBNP were higher than those of the HFpEF group,with statistically significant differences(all P<0.05).The correlation analysis showed that QRS wave duration,soluble ST2,NT-proBNP were negatively correlated with LVEF in patients with HFrEF(all P<0.05).In the HFrEF group,the patients with poor prognosis had lower LVEF compared with those with good prognosis,and higher QRS wave duration,soluble ST2,NT-proBNP,with statistically significant differences(all P<0.05).The parallel combination of the four indicators had the highest sensitivity(92.4%),and the series combination had the highest specificity(93.7%).Conclusion Ultrasound combined with soluble ST2 and NT-proBNP is a feasible method for diagnosing heart failure with reduced
作者
卢翠碧
霍志成
王飞
陈仕兰
王英杰
Lu Cuibi;Huo Zhicheng;Wang Fei;Chen Shilan;Wang Yingjie(Dongguan Binhaiwan Central Hospital,Dongguan 523900,China)
出处
《国际医药卫生导报》
2020年第11期1547-1549,1556,共4页
International Medicine and Health Guidance News
基金
东莞市社会科技发展(一般)项目(2018507150251298)。
