和肽素联合N末端B型利钠肽原评估慢性心力衰竭患者预后的价值  

Prognostic Value Assessment of Copeptin and NT-proBNP in Patients With Chronic Heart Failure

作　　者：赵玉清[1] 袁桂莉[2] 张进顺[1] 闫青叶[2] 李方江[2] 王晓芸[3] 杨淼[4] 

机构地区：[1]河北北方学院,河北省张家口市075000 [2]河北北方学院附属第一医院心内科 [3]河北北方学院附属第一医院药剂科 [4]河北北方学院附属第一医院急诊科

出　　处：《中国循环杂志》2014年第4期275-278,共4页Chinese Circulation Journal

摘　　要：目的:探讨和肽素联合N末端B型利钠肽原(NT-proBNP)评估慢性心力衰竭患者预后的价值。方法:选择2012-01至2012-10在河北北方学院附属第一医院心内科住院的145例慢性心力衰竭患者。测定并记录患者血和肽素、NT-proBNP浓度。出院后随访12个月,根据随访结果分为心脏事件组和无复发事件组,心脏事件组包括心原性死亡患者及因心力衰竭恶化再次入院患者,分析两组和肽素、NT-proBNP水平与心脏事件的关系。结果:心脏事件组血浆和肽素、NT-proBNP浓度均高于无复发事件组,差异具有统计学意义(P<0.05)。根据和肽素、NT-proBNP对慢性心力衰竭患者预后判定的ROC曲线,慢性心力衰竭患者血和肽素、NT-proBNP浓度符合预测心脏事件的条件。将血和肽素水平为11.36 pg/mol、血NT-proBNP水平为1023.90 ng/L作为慢性心力衰竭患者危险分层界值,绘制Kaplan-Meier生存曲线显示,高危组与低危组两组发生心脏事件比较差异具有统计学意义(P<0.05)。结论:慢性心力衰竭患者血和肽素、NT-proBNP浓度越高,发生心脏件的风事险越高,检测慢性心力衰竭患者血浆中和肽素、NT-proBNP浓度对慢性心力衰竭患者危险分层及预后评估都具有一定的临床价值。Objective： To explore the prognostic value of copeptin and NT-proBNP in patients with chronic heart failure （CHF）. Methods： A total of 145 CHF patients treated in our hospital from 2012-01 to 2012-10 were studied. The plasma levels of copeptin and NT-proBNP were recorded, the patients were followed-up for 12 months and divided into 2 groups. Cardiac event group, n=63 patients with cardiac death, readmission for worsening heart failure, and No cardiac event group, n=74. The relationship between the levels of copeptin, NT-proBNP and the cardiac events was analyzed. Results： There were 137 patients finished the follow-up and 8 （5.52%） lost contact. Compared with No cardiac event group, the Cardiac event group had higher levels of copeptin and NT-proBNP, P〈0.05. According to ROC curve analysis, the levels of copeptin and NT-proBNP matching the prognostic condition for cardiac event. Taking Copeptin 11.36 pg/mol and NT-proBNP 1023.90 ng/L as the cut-off point for risk stratification, the Kaplan-Meier survival curve displayed that there was significant difference between high risk and low risk patients for cardiac event occurrence in CHF patients, P〈0.05. Conclusion： Increased plasma levels of copeptin and NT-proBNP could predict the prognosis at certain degree for CHF patients.

关 键 词：慢性心力衰竭 和肽素 N末端B型利钠肽原 危险分层 预后 

分 类 号：R54[医药卫生—心血管疾病]