N末端B型利钠肽原在评估慢性心肾综合征患者预后中的价值  

Analysis of Prognostic Value of N-Terminal Pro-Brain Natriuretic Peptide in Patients With Chronic Cardiorenal Syndrome

作　　者：刘启云[1,2] 陈彩敏 梁新剑[1,2] 李江华 董少红[1,2] 

机构地区：[1]暨南大学第二临床医学院 [2]深圳市人民医院心内科,广东省深圳市518020

出　　处：《中国循环杂志》2013年第6期442-445,共4页Chinese Circulation Journal

摘　　要：目的 :探讨不同N末端B型利钠肽原(NT-proBNP)水平评估慢性心肾综合征(CRS)患者预后的价值。方法 :137例CRS患者入院后测定血液NT-proBNP水平,行超声心动图及组织多普勒检查,根据NT-proBNP水平分为低NT-proBNP组(≤4 647 pg/ml)和高NT-proBNP组(>4 647 pg/ml),对两组患者2年随访期间的数据及心血管事件发生率进行统计分析。结果:低NT-proBNP组和高NT-proBNP组左心室射血分数(LVEF)分别为(57.9±7.8)%和(44.4±7.1)%(P<0.01)。总心血管事件发生率分别为8.0%和62.9%(P<0.01)。全部患者人群中NT-proBNP水平与左心室射血分数呈负相关(r=-0.748,P<0.01),与组织多普勒心肌做功指数(TDI-Tei)呈正相关(r=0.737,P<0.01),与估算肾小球滤过率(eGFR)呈负相关(r=-0.628,P<0.01)。NT-proBNP水平预测CRS患者2年内发生心血管事件的ROC曲线下面积为0.838,敏感性和特异性分别为88.9%和75.0%。以NT-proBNP水平4 647 pg/ml作为分组的界值,通过Kaplan-Meier法作NTproBNP不同水平患者在2年随访期间心血管事件发生率曲线,计算Log-rank检验统计量为51.673(P<0.001)。结论:NT-proBNP水平可以预测慢性心肾综合征患者的预后,界值超过4 647 pg/ml的患者预后较差。Objective：To analyze the prognostic value of N-terminal pro-brain natriuretic peptide （NT-proBNP） in patients with chronic cardio renal syndrome （CRS）.Methods：We summarized a total of 137 chronic CRS patients in our hospital for their blood NT-proBNP levels,and the patients were divided into 2 groups as low NT-proBNP group （BNP≤ 4647pg/ml）,n=75 and high NT-proBNP group （BNP＞4647 pg/ml）,n=62.The echocardiography,tissue Doppler imaging were conducted and the incidence of cardiovascular events were followed-up for 2 years in both groups.Results：Left ventricular ejection fractions （LVEF） in Low NT-proBNP group and High NT-proBNP group were （57.9 ± 7.8）％ vs （44.4 ± 7.1）％,P＜0.01,and the total cardiovascular events were 8.0％ vs 62.9％,P＜0.01.The NT-proBNP level was negatively related to LVEF （r=-0.748,P＜0.01） and eGRF （r=-0.628,P＜0.01）,while positively related to Tei-index （r=0.737,P＜0.01）.The NT-proBNP level for predicting the cardiovascular events within 2 years by the area under ROC curve was 0.838,with the sensitivity of 88.9％ and the specificity of 75.0％.Taking NT-proBNP 4 647 pg/ml as the cut-off value,the incidence of cardiovascular events in CRS patients for 2 years by Log-rank Kaplan-Meier calculation was 51.673,P=0.001.Conclusion：Blood NT-proBNP level could predict the prognosis in CRS patients,and NT-proBNP＞4 647 pg/ml with worsen condition.

关 键 词：心肾综合征 脑钠肽 预后 

分 类 号：R54[医药卫生—心血管疾病]