摘要
目的:研究心力衰竭超声指数(HFEI)联合血清肌钙蛋白I(cTnI)、脑钠肽(BNP)对老年舒张性心力衰竭患者不良心血管事件(MACE)的预测价值。方法:将医院从2018年1月2019年12月期间收治的80例老年舒张性心力衰竭患者纳入研究。将其按照随访1年结局的差异分作研究组(发生MACE)35例和对照组(未发生MACE)45例。检测并比较两组HFEI以及血清cTnI、BNP水平,同时分析两组基线资料以及心功能指标水平的差异。通过多因素Logistic回归分析明确MACE的相关影响因素,并以受试者工作特征(ROC)曲线分析HFEI以及血清cTnI、BNP联合预测MACE的效能。结果:研究组HFEI以及血清cTnI、BNP水平均高于对照组(均P<0.05)。研究组年龄和左室舒张末期内径(LVEDd)均高于对照组,而左室射血分数(LVEF)、二尖瓣血流频谱E峰和A峰比值(E/A)比值均低于对照组(均P<0.05)。经多因素Logistic回归分析可得:HFEI以及血清cTnI、BNP水平均是老年舒张性心力衰竭患者MACE的独立危险因素(均OR>1,P<0.05)。经ROC曲线分析可得:HFEI以及血清cTnI、BNP联合预测MACE的曲线下面积、灵敏度、特异度、约登指数均高于上述三项指标单独检测。结论:HFEI以及血清cTnI、BNP在预测老年舒张性心力衰竭患者MACE方面的价值较高,值得临床推广应用。
Objective: To study the predictive value of heart failure echocardiography index(HFEI) combined with serum troponin I(cTnI) and brain natriuretic peptide(BNP) on adverse cardiovascular events(MACE) in elderly patients with diastolic heart failure.Methods: From January 2018 to December 2019, 80 elderly patients with diastolic heart failure were included in this study. The patients were divided into 35 cases in the study group(occurred MACE) and 45 in the control group(no occurred MACE) according to the outcome difference of 1-year follow-up. HFEI and the levels of serum cTnI and BNP were detected and compared between the two groups, and the differences in baseline data and cardiac function indexes between the two groups were analyzed. Multivariate Logistic regression analysis was used to identify the related factors of MACE, and receiver operating characteristic(ROC) curve was used to analyze the efficacy of HFEI and serum cTnI and BNP in predicting MACE. Results: The HFEI and the levels of serum cTnI, BNP in study group were higher than those in control group(all P<0.05). The age and left ventricular end diastolic diameter(LVEDd) in the study group were higher than those in the control group, while the left ventricular ejection fraction(LVEF) and E and A peaks in the mitral valve flow spectrum(E/A) ratio were lower than those in the control group(all P<0.05). Multivariate Logistic regression analysis showed that HFEI, the levels of serum cTnI and BNP were independent risk factors for MACE in elderly patients with diastolic heart failure(all OR >1, P<0.05). The ROC curve analysis showed that the area under the curve, sensitivity, specificity and Youden index of MACE predicted by HFEI combined with serum cTnI and BNP were all higher than those of the above three indexes detected alone.Conclusion: HFEI, serum cTnI and BNP have high value in predicting MACE in elderly patients with diastolic heart failure, which is worthy of clinical application.
作者
孙媛媛
余其贵
鲁朝玉
程秀俊
谢军
SUN Yuan-yuan;YU Qi-gui;LU Zhao-yu;CHENG Xiu-jun;XIE Jun(Department of General Practice,Hefei Hospital Affiliated to Anhui Medical University/Hefei Second People's Hospital,Hefei,Anhui,230011,China)
出处
《现代生物医学进展》
CAS
2021年第14期2753-2757,共5页
Progress in Modern Biomedicine
基金
安徽省公益性技术应用研究联动计划项目(1704f0804042)。
关键词
舒张性心力衰竭
心力衰竭超声指数
肌钙蛋白I
脑钠肽
不良心血管事件
Diastolic heart failure
Heart failure echocardiography index
Troponin I
Brain natriuretic peptide
Adverse cardiovascular events
