和肽素与大内皮素-1及N末端脑钠肽对心力衰竭的预后价值  

Prognostic Value of Copeptin,Big Endothelin-1 and N-Terminal Pro-Brain Natriuretic Peptide in Patients with Chronic Heart Failure

作　　者：汪隆海[1] 陈启松[2] 夏芳[1] 方超[1] 何海军[2] 张平[3] 

机构地区：[1]安徽省含山县人民医院检验科,安徽含山238100 [2]安徽省含山县人民医院心内科,安徽含山238100 [3]安徽省含山县人民医院彩超室,安徽含山238100

出　　处：《现代检验医学杂志》2015年第1期64-67,71,共5页Journal of Modern Laboratory Medicine

摘　　要：目的：通过对心力衰竭患者的随访研究，探讨和肽素与大内皮素-1（Big ET-1）及N末端脑钠肽（NT-proBNP）对心力衰竭患者的预后价值。方法研究159例心力衰竭住院患者，检测入院时血清和肽素，NT-proBNP，肌钙蛋白 I，CKMB和血浆Big ET-1与左室射血分数以及 NYHA分级。并随访观察患者出院后360-490天的心血管事件再发生情况。结果159例心力衰竭患者的中位随访385天，发生心脏事件65例。多元典型相关分析显示心力衰竭患者的年龄越大和NYHA分级越高及 LVEF越低，则心力衰竭患者的和肽素与Big ET-1及 NT-proBNP的浓度越高。Cox比例风险模型分析显示，年龄、和肽素和Big ET-1及NT-proBNP是独立的心脏事件再发生的预后因素，风险比分别为1.215，1.236，4.031和13.052。logistic回归分析显示，和肽素与 Big ET-1及 NT-proBNP是独立的心源性死亡的危险因素，优势比分别为4.003，2.477 和1.235。结论检测和肽素与Big ET-1及 NT-proBNP可对心衰患者进行心脏事件再发生的危险分层和预后分析。Objective To investigate the prognostic factors for chronic heart failure and the prognostic ability of copeptin,big endothelin-1（Big ET-1）and N-terminal pro-brain natriuretic peptide （NT-proBNP）in patients with chronic heart failure. Methods To study 1 5 9 consecutive patients hospitalized for chronic heart failure.Serum concentration of copeptin,NT-proBNP,cTnI,CKMB and plasma Big ET-1 as well as left ventricular ejection fraction （LVEF）and NYHA classⅠtoⅣ on admission were measured.Cardiac events were found by patients to discharge after 360-490 days,prospectively.Results During a median follow-up period of 385 days,the endpoint of recurrence for cardiac events was reached in 65 patients with 159 heart failure.Multivarlate canonical correlation analysis shows the older and the higher NYHA classification as well as the lower LVEF in patients with heart failure.There were higher concentration of copeptin,Big ET-1 and NT-proBNP.On a Cox proportional hazards regression models analyses,age,copeptin,Big ET-1 and NT-proBNP were found to be the independent predictors of cardiac events.Risk ratio （RR）were 1.215,1.236,4.031 and 13.052,respectively.Logistic regression models analyses,copeptin,Big ET-1 and NT-proBNP were found independent predictors of death.Odd ratio （OR）were 4.003,2.477 and 1.235,respectively.Conclusion Measurement of copeptin,Big ET-1 and NT-proBNP in patients with chronic heart failure can help to identify patients at higher risk for cardiac events and patients for prognosis.

关 键 词：和肽素 内皮素 脑钠肽 心力衰竭 充血性 预后 

分 类 号：R541.6[医药卫生—心血管疾病] R446.112[医药卫生—内科学]