血浆NT-proBNP水平及肺动脉收缩压对慢性左心心力衰竭病人预后的预测价值  

THE VALUE OF PLASMA NT-PROBNP AND PULMONARY ARTERY SYSTOLIC PRESSURE IN PREDICTING PROGNOSIS OF PATIENTS WITH CHRONIC LEFT HEART FAILURE

作　　者：王全政 秦毅[2] 沃金善[1] 

机构地区：[1]青岛大学医学院附属医院心内科,山东青岛2660031 [2]青岛大学医学院附属医院

出　　处：《齐鲁医学杂志》2014年第5期439-441,共3页Medical Journal of Qilu

摘　　要：目的探讨N末端B型脑钠肽原（NT-proBNP）及肺动脉收缩压对慢性左心心力衰竭病人预后的预测价值。方法慢性左心心力衰竭病人142例,测定病人NT-proBNP、肺动脉收缩压等指标,随访出院1年后心血管事件的发生情况。结果肺动脉收缩压≥6.67kPa组较肺动脉收缩压〈6.67kPa组1年期终点事件发生率明显升高,差异具有显著性（χ2=17.045,P〈0.05）;NT-proBNP浓度≥2 218ng/L组较NT-proBNP浓度〈2 218ng/L 1年期终点事件发生率明显升高,差异有显著意义（χ2=54.685,P〈0.05）;终点事件组和非终点事件组肺动脉收缩压、血浆NT-proBNP浓度相比较差异有显著意义（t=-9.804、5.940,P〈0.05）;NT-proBNP和肺动脉收缩压预测慢性左心心力衰竭1年期预后的ROC曲线下面积分别为0.970（95%CI=0.912-1.000,P〈0.05）和0.784（95%CI=0.691-0.878,P〈0.05）。结论 NT-proBNP和肺动脉收缩压是慢性左心心力衰竭病人1年期预后的危险因素,NT-proBNP及肺动脉收缩压均可用于慢性左心心力衰竭病人1年期预后的评估,但NT-proBNP较肺动脉收缩压有更好的预测价值。Objective To assess the predictive value of NT-proBNP and pulmonary artery systolic pressure（PASP）for chronic left ventricular failure（CLVF）. Methods This study consisted of 142 patients with CLVF.Their NT-proBNP and PASP were measured and followed one year after discharge for the incidence of cardiovascular events. Results The incidence of one-year endpoint events in patients with LASP≥6.67 kPa was higher than that in those with LASP 6.67 kPa,the difference was statistically significant（χ2=17.045,P〈0.05）;and the patients with LASP and NT-proBNP concentration≥2 218ng/L had a higher one-year endpoint events than those with NT-proBNP concentrations2 218ng/L（χ2=54.685,P〈0.05）.The differences of LASP and plasma NT-proBNP concentration between endpoint event group and non-endpoint event were significant（t=-9.804,5.940;P〈0.05）.The areas under the ROC curve of NT-proBNP and PASP to predict one-year prognosis were 0.970（95%CI=0.912-1.000,P〈0.05）,and 0.784（95%CI=0.691-0.878,P〈0.05）,respectively. Conclusion NT-proBNP and pulmonary artery systolic pressure are both risk factors of one-year prognosis in patients with chronic left heart failure,and the above two parameters can also be used to assess one-year prognosis in patients with this disease,but NT-proBNP is preferable to pulmonary artery systolic pressure for the prediction.

关 键 词：心力衰竭 充血性 利钠肽 脑 肺动脉压力 预后 

分 类 号：R544.11[医药卫生—心血管疾病]