降钙素原对左心室射血分数正常心力衰竭患者病情预后判断价值  

The prognosis evaluation of serum procalcitonin levels in heart failure patients with preserved ejection fraction

作　　者：王浩 李霞[2] 林良毅 王萍 林少华[3] 

机构地区：[1]山东省荣成市中医院心内科,264300 [2]山东省济宁市第一人民医院肾内科,72000 [3]泰山医学院附属荣成医院重症医学科,山东荣成264300

出　　处：《蚌埠医学院学报》2015年第3期348-350,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨左心室射血分数正常心力衰竭(HFPEF)患者外周血清降钙素原(PCT)水平动态变化及其对预后的预测价值。方法:选择HFPEF患者125例,入院1、2、3、5 d抽取肘静脉血检测PCT指标,并记录当日急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)、序贯器官衰竭评分(SOFA)。根据14 d生存情况分为存活组和病死组,比较2组PCT水平及APACHEⅡ评分、SOFA评分,并分析各指标之间的相关性。结果:病死组入院1、2 d外周血PCT水平与存活组差异均无统计学意义(P>0.05),但入院3 d和5 d PCT水平与APACHEⅡ、SOFA评分均呈显著正相关关系(P<0.01)。受试者工作特征曲线显示,入院3 d PCT水平对14 d病死率有一定的预测价值,曲线下面积为0.815。结论:动态监测血PCT水平的变化有助于判断HFPEF患者的预后。Objective： To investigate the prediction value of peripheral blood procalcitonin（ PCT） levels in the prognosis evaluation of patients with heart failure with preserved ejection fraction（ HFPEF）. Methods： One hundred and twenty-five patients with HFPEF were enrolled. Serum PCT levels were monitored,and the acute physiology and chronic health evaluation Ⅱ（ APACHE Ⅱ） score,sequential organ failure assessment（ SOFA） score were recorded at the 1st,2nd,3rd and 5th day. According to the 14-day outcome after admission,the patients with HFPEF were divided into survivor group and non-survivor group,the dynamic changes of serum PCT levels,APACHE Ⅱ score and SOFA score were compared between the two groups and the correlation analysis was carried out. Results： There was no significant difference in serum PCT levels at the 1st and 2nd day between survivor group and non-survivor group（ P 0.〉 05）,but the positive statistical correlation was found between serum PCT levels and APACHE Ⅱ score,SOFA score in non-survivor group（ P〈 0. 01）. Receiver operator characteristic curve revealed serum PCT levels on the 3rd day could significantly predict the 14-day mortality,maximal area under the curve of serum PCT was 0. 815. Conclusions： Dynamic monitoring of serum PCT levels could help to assessment the prognosis of patients with HFPEF,also to predict the severity of the illness.

关 键 词：心力衰竭 降钙素原 射血分数 预后 

分 类 号：R541.6[医药卫生—心血管疾病]