血浆氨基末端B型利钠肽原检测在慢性心力衰竭患者住院期间主要心血管不良事件评估中的价值  

The clinical value of plasma NT-proBNP detection in evaluation of major adverse cardiac event in chronic heart failure patients during＂ hospitalization

作　　者：张春德[1] 刘家威[1] 陈斌[1] 张爱萍[1] 

机构地区：[1]淮南市第一人民医院心内科,安徽省淮南232007

出　　处：《中国基层医药》2013年第20期3050-3052,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：安徽省淮南市科技项目（2011A07402）

摘　　要：目的 探讨血浆氨基末端B型利钠肽原（NT-proBNP）评估慢性心力衰竭患者住院期间心血管不良事件的临床价值.方法 选择120例符合诊断的单纯性慢性心力衰竭患者,入院时测定血浆NT-proBNP的水平,将患者分为≤中位数血浆NT-proBNP浓度组（A组）和＞中位数血浆NT-proBNP浓度组（B组）,观察两组住院期间发生室性心律失常及心脏性猝死情况.结果 B组患者左室舒张末内径明显大于A组患者[（58.80±6.90）mm比（54.32±8.00） mm,P=0.035],而B组患者的左室射血分数则明显低于A组患者[（29.16±8.31）％比（33.80±6.90）％,P=0.037]；B组患者心血管不良事件发生率（11.63％）明显高于A组（1.67％）（P＜0.05）.经多变量（心脏左室舒张末内径、左室射血分数、血钾水平及血浆NT-proBNP水平）Logistic回归分析显示NT-proBNP水平与心力衰竭患者发生心血管不良事件的独立相关（OR=5.28,95％可信区间3.54～9.26,P＜0.05）.结论 慢性心力衰竭患者血浆NT-proBNP水平可预测其住院期间心血管不良事件发生率,对评估慢性心力衰竭患者临床预后及指导治疗具有重要临床价值.Objective To explore the clinical value of plasma NT-proBNP in evaluation of major adverse cardiac event in chronic heart failure patients. Methods 120 chronic heart failure patients who measured plasma NTproBNP were divided into two groups according to median plasma NT-proBNP level （ A group ： ≤ median, B group ≥ median）. The incidence of major adverse cardiac events, MACE （ including malignant ventricular arrhythmia and sudden cardiac death） were observed during hospitalization. Results The left ventricular end-diastolic diameters （LVEDDs） in B group was longer than that in A group [ （58.80 ± 6.90） mm vs （ 54.32 ± 8.00） mm, P = O. 035 ） ], and the left ventricular ejection fraction（LVEF） in B group was lower than that in A group [ （ 29.16±8.31 ） % vs （33.80±6.90） %, P = 0. 037 ]. The incidence rate of major adverse cardiac events in A group was higher than that in B group （ 11.63 % vs 1.67%, P 〈 O. 05 ）. The multivariate Logistic regression analysis showed that the NT-proBNP level in chronic heart failure inpatients was independently associated with major adverse cardiac event during hospitalization（ OR = 5.28,95% confidence intervals 3.54 - 9.26, P 〈 0.05 ）. Conclusion In chronic heart failure patients, plasma NT-proBNP level could predict the MACE incidence during hospitalization, and have important value to evaluate the prognosis of chronic heart failure.

关 键 词：心力衰竭 充血性 心脏功能试验 利钠肽 脑 

分 类 号：R541.6[医药卫生—心血管疾病]