摘要
目的探讨N末端B型利钠肽(NT-ProBNP)、C反应蛋白(CRP)联合尿酸(UA)及超声心动图对冠心病合并心力衰竭的诊断价值。方法选取2018年6月至2020年12月首都医科大学附属北京世纪坛医院住院部收治的135例冠心病合并心力衰竭患者作为观察组;以同期进行治疗的102例冠心病患者作为单纯冠心病组;选取同期110例健康体检者设为对照组。比较三组及不同心功能分级的冠心病合并心力衰竭患者NT-ProBNP、CRP及UA水平及心功能参数指标水平。绘制ROC曲线,分析NT-ProBNP、CRP、UA水平及心功能参数指标对患者心功能分级的预测价值。结果三组NT-ProBNP、CRP、UA、LVEDV、LVESV比较:观察组>单纯冠心病组>对照组,差异有统计学意义(P<0.05)。三组LVEF比较:观察组<单纯冠心病组<对照组,差异有统计学意义(P<0.05)。不同心功能分级的患者NT-ProBNP、CRP、UA、LVEDV、LVESV比较:Ⅳ级>Ⅲ级>Ⅱ级>Ⅰ级,差异有统计学意义(P<0.05)。不同心功能分级的患者LVEF比较:Ⅳ级<Ⅲ级<Ⅱ级<Ⅰ级,差异有统计学意义(P<0.05)。NT-ProBNP+CRP+UA+超声心动图心功能参数四者联合检测冠心病合并心力衰竭诊断的灵敏度(0.989)、特异度(0.993)、AUC(0.980)均显著高于单一指标检测(P<0.05)。结论NT-ProBNP+CRP+UA+超声心动图心功能参数联合检测可为强化冠心病合并心力衰竭诊断、判断预后提供参考。
Objective To investigate the diagnostic value of the N⁃terminal pro brain natriuretic peptide(NT⁃ProBNP),C⁃reactive protein(CRP),Uric acid(UA)and echocardiography in coronary heart disease complicated with heart failure.Methods 135 patients with coronary heart disease and heart failure admitted to the inpatient department of Beijing Shijitan Hospital,Capital Medical University from June 2018 to December 2020 were selected as the observation group.102 patients with coronary heart disease who were treated in this hospital during the same period were taken as the simple coronary heart disease group.110 healthy subjects in the hospital were set as a control group.The levels of NT⁃ProBNP,CRP,UA and cardiac function parameters were compared among the three groups and in patients with coronary heart disease and heart failure with different cardiac function grades.The ROC curve was drawn to analyze the predictive value of NT⁃ProBNP,CRP,UA levels and cardiac function parameters on the cardiac function classification of patients.Results Comparison of NT⁃ProBNP,CRP,UA,LVEDV,LVESV among the three groups:observation group>pure coronary heart disease group>control group,the difference was statistically significant(P<0.05).Comparison of LVEF among the three groups:observation group<pure coronary heart disease group<control group,the difference was statistically significant(P<0.05).Comparison of NT⁃ProBNP,CRP,UA,LVEDV,LVESV in patients with different cardiac function grades:gradeⅣ>gradeⅢ>gradeⅡ>gradeⅠ,the difference was statistically significant(P<0.05).Comparison of LVEF in patients with different cardiac function grades:gradeⅣ<gradeⅢ<gradeⅡ<gradeⅠ,the difference was statistically significant(P<0.05).The sensitivity(989),specificity(0.993)and AUC(0.980)of NT⁃ProBNP+CRP+UA+echocardiographic cardiac function parameters in the combined detection of coronary heart disease combined with heart failure were significantly higher than the single indicator detection(P<0.05).Conclusion The combined detectio
作者
赵雪利
张德贤
王彦婷
刘滕飞
ZHAO Xueli;ZHANG Dexian;WANG Yanting;LIU Tengfei(Department of Cardiovascular Medicine,Beijing Shijitan Hospital,Capital Medical University,Beijing,China,100038)
出处
《分子诊断与治疗杂志》
2022年第1期49-53,共5页
Journal of Molecular Diagnostics and Therapy
基金
首都医科大学附属北京世纪坛医院实验室院内开放课题(2019-KF28)。
