血浆N末端B型利钠肽原水平评估心力衰竭患者预后的价值  

Prognostic Value of Plasma NT-proBNP in Patients with Heart Failure

作　　者：宋涛[1] 姚园[1] 

机构地区：[1]武汉大学人民医院心内科,湖北武汉430060

出　　处：《医学临床研究》2014年第2期262-265,共4页Journal of Clinical Research

摘　　要：【目的】探讨血浆N末端B型利钠肽原（NT-proBNP）水平评估心力衰竭患者预后的价值。【方法】选择100例心衰住院患者，在入院d2常规行心脏彩超及血液生化检查，并测定患者血浆中N T-proBN P水平。对患者的一般资料、心脏彩超、NT-proBNP水平及18个月随访期内心脏不良事件发生率进行分析。按随访期内是否发生心脏不良事件分为事件组与非事件组，根据 NT-proBNP水平高低分为高 NT-proBNP组（NT-proBNP＞3200 pg/mL）和低NT-proBNP组（NT-proBNP≤3200 pg/mL），并对相关数据进行统计学分析。【结果】事件组NT-proBNP水平较非事件组明显增高（ P ＜0．001）。多因素logistic回归分析显示只有NT-proBNP是预测心脏不良事件发生的独立危险因素。NT-proBNP水平预测心衰患者18个月内死亡的ROC曲线下面积为0．873，以随访患者平均NT-proBNP水平均数3200 pg/mL作为分组的界值，通过Kaplan-Meier法作NT-proBNP不同水平患者在随访期间心脏不良事件发生率曲线，计算Log-rank为29．563（ P ＝0．000）。【结论】 NT-proBNP水平是心衰患者发生心脏不良事件的独立危险因素之一，不同 N T-proBN P水平对心衰患者的预后影响不同，超过3200 pg/mL的患者预后较差。[Objective]To explore the prognostic value of plasma NT-proBNP in patients with heart failure .[Methods]Totally 100 inpatients with heart failure were enrolled in the study .Color echocardiography and blood biochemical examination were performed at second day after admission .Plasma NT-proBNP of patients was meas-ured .The general data ,color echocardiography ,NT-proBNP and the incidence of adverse cardiac events during 18 months of follow up were analyzed .According to the incidence of adverse cardiac events during the follow up ,all patients were divided into event group and non-event group .According to the level of NT-proBNP ,all patients were divided into high NT-proBNP group（NT-proBNP〉3200pg/ml） and low NT-proBNP group（NT-proBNP≤3200pg/mL） .The data was analyzed by statistics .[Results]Compared with non-event group ,NT-proBNP level in event group increased obviously（ P 〈0 .001） .Multiple logistic regression analysis showed that only NT-proBNP was an independent risk factor for adverse cardiac events .The area under ROC curve for predicting cardiac death of heart failure patient within 18 months by NT-proBNP was 0 .873 .The mean NT-proBNP with 3200pg/mL in pa-tients during follow up was taken as the value for the grouping .The curve of the incidence of adverse cardiac e-vents of patients with different level of NT-proBNP during follow up was made by using Kaplan-Meier method . Log-rank was calculated and 29 .563（ P =0 .0000） .[Conclusion] NT-proBNP level is an independent risk factor of adverse cardiac events in patients with heart failure .The influence of different level of NT-proBNP on the prog-nosis of patients with heart failure is different .Patients with NT-proBNP ≥3200pg/mL have poor prognosis .

关 键 词：心力衰竭 利钠肽  脑 预后 

分 类 号：R541.61[医药卫生—心血管疾病]