摘要
目的探讨内皮素(ET)联合N末端脑钠肽前体(NT-proBNP)在老年ST段心肌梗死心房颤动患者预后评估中的价值。方法选取2019年1月至2020年6月就诊于石家庄市人民医院老年ST段抬高型心肌梗死患者450例,均行PCI术治疗,根据术前是否合并心房颤动,分为对照组(无心房颤动,n=390)和观察组(心房颤动,n=60),比较2组患者PCI术后红细胞分布宽度(RDW)、ET、NT-proBNP水平情况;随访2年,比较2组主要不良心脑血管事件(MACCE)发生情况,采用多因素Logistic回归分析影响患者心房颤动发生的相关因素,采用受试者工作特征曲线(ROC)分析ET联合NT-proBNP对患者预后的早期预测价值。结果观察组RDW、ET、NT-proBNP高于对照组(P<0.05)。随访2年,观察组MACCE发生率明显高于对照组(P<0.05)。经Logistic回归分析,ET(OR=1.836,P=0.002)、NT-proBNP(OR=1.952,P=0.001)是患者发生心房颤动的独立危险因素。ET联合NT-proBNP对患者不良预后预测ROC曲线下面积为0.936,灵敏度为92.8%,特异度为91.6%。结论ET、NT-proBNP指标是老年ST段心肌梗心房颤动患者PCI术后评估的重要指标,并对其预后判断具有一定临床意义。
Objective To explore the prognostic value of endothelin(ET)combined with N-terminal pro brain natriuretic peptide(NT-proBNP)in elderly patients with atrial fibrillation(AF)after ST-elevation myocardial infarction(STEMI).Methods A total of 450 elderly patients with STEMI who visited Shijiazhuang People’s Hospital from January 2019 to June 2020 and treated with percutaneous coronary intervention(PCI)were recruited.They were allocated to control group(no atrial fibrillation,n=390)and observation group(atrial fibrillation,n=60)according to the absence or presence of AF before PCI.The red blood cell distribution width(RDW),ET and NT-proBNP levels after PCI were compared between the two groups.Patients were followed up for 2 years,and the incidence of major adverse cardiovascular and cerebrovascular events(MACCEs)was compared.Multivariate logistic regression was performed to identify risk factors for AF in elderly patients with STEMI.The receiver operating characteristic(ROC)curves were plotted to analyze the early prognostic value of ET combined with NT proBNP in elderly patients with AF after STEMI.Results RDW,ET and NT-proBNP levels in the observation group were significantly higher than those in the control group(P<0.05).The 2-year follow-up incidences of MACCEs in the observation group were significantly higher than those in the control group(P<0.05).ET(OR=1.836,P=0.002)and NT-proBNP levels(OR=1.952,P=0.001)were independent risk factors for AF in elderly patients with STEMI in logistic regression analysis.The area under the curve(AUC)of ET combined with NT-proBNP in diagnosing AF in elderly patients with STEMI was 0.936,with the sensitivity and specificity of 92.8%and 91.6%,respectively.Conclusion ET and NT proBNP are important indexes for evaluating the prognosis of elderly patients with STEMI and AF after PCI.It has certain clinical significance for its prognosis.
作者
郑丽娟
齐婧贤
温慧
吴琳
朱磊
ZHENG Lijuan;QI Jingxian;WEN Hui(不详;Catheter Room,Shijiazhuang People’s Hospital,Hebei,Shijiazhuang 050011,China)
出处
《河北医药》
CAS
2023年第14期2137-2140,共4页
Hebei Medical Journal
基金
石家庄市科学技术研究与发展计划项目(编号:201460883)。
关键词
内皮素
N末端脑钠肽前体
ST段心肌梗死
心房颤动
主要不良心脑血管事件
预后
endothelin
N-terminal pro brain natriuretic peptide
ST-elevation myocardial infarction
atrial fibrillation
major adverse cardiovascular and cerebrovascular events
prognosis
