血浆N端脑利钠肽前体和胆固醇水平联合预测心脏瓣膜病患者恶性心律失常的价值  

Value of plasma NT-proBNP and cholesterol levels of patients with heart valve disease predicting malignant arrhythmia

作　　者：李春芝[1] 赵鑫[1] 

机构地区：[1]河北省人民医院,河北石家庄050051

出　　处：《中国临床医生杂志》2017年第1期29-32,共4页Chinese Journal For Clinicians

摘　　要：目的探讨血浆N端脑利钠肽前体(NT-proBNP)和胆固醇(TC)水平联合预测心脏瓣膜病患者恶性心律失常(MA)的价值。方法选取心脏瓣膜病患者168例作为研究组,另选取30例同期健康查体者作为对照组。采用酶联免疫吸附法检测两组术前(T_0)、术后1天(T_1)、3天(T_2)、1周(T_3)和1个月(T_4)的血浆NT-proBNP和TC水平。统计研究组随访2年期间MA发生情况,并根据其MA发生情况分为MA组(n=18)和非MA组(n=150)两个亚组,比较两组围术期血浆NT-proBNP和TC水平,并采用受试者操作特性曲线(ROC)分析心脏瓣膜病患者血浆NT-proBNP和TC水平联合预测其MA的价值。结果与对照组比较,研究组围术期的血浆NT-proBNP和TC水平均升高;与T_0比较,研究组T_1、T_3和T_4的血浆NT-proBNP和TC水平均降低(P<0.05)。研究组MA发生率为10.71%(18/168),且MA组同术期的血浆T-proBNP和TC水平均高于非MA组(P<0.05)。ROC曲线分析结果显示,以728.28 pg/ml和4.15 mmol/L为血浆NT-proBNP和TC水平临界值时,AUC=0.884(95%CI 0.791~0.936),曲线上MA患者17例,敏感度为94.44%,曲线下非MA患者148例,特异度为98.67%,准确性、阳性预测值和阴性预测值分别为98.21%、89.47%和99.33%,心脏瓣膜病患者血浆NT-proBNP和TC水平联合预测其MA的价值良好。结论心脏瓣膜病患者血浆NT-proBNP和TC水平均较高,且两者联合预测其MA的价值良好,这可能和NT-proBNP与患者心功能损伤相关及TC调节心脏电解质平衡作用相关,心脏瓣膜病患者血浆NT-proBNP和TC水平可能用于其MA的预测,为其预后改善提供依据。Objective To investigate the value of plasma n-terminal brain natriuretic peptide precursor（NT-proBNP）and cholesterol（TC） levels of patients with heart valve disease predicting malignant arrhythmia（MA）.Method 168 patients with heart valve disease in our hospital were randomly selected as research group,and other 30 healthy persons who had physical examination in the same period were selected as control group.Enzyme-linked immunosorbent was applied in detection of plasma NT-proBNP and TC levels of he control group and the research group preoperative（T0）.postoperative ld（T1）,3d（T2）,1 week（T3）,and 1 month（T4）.The research group were followed up for two years and the occurrence of MA were statistically analyzed.The research group were divided into MA group（n= 18）and non-MA group（n= 150） two subgroups according to the occurrence of MA.perioperative plasma NT-proBNP and TC levels of MA group and non-MA group were compared and receiver operating characteristic curve（ROC） was applied in analysis of value of plasma NT-proBNP and TC levels of patients with heart valve disease predicting the MA.Result Compared with control group,perioperative plasma NT-proBNP and TC levels of the research group were increased;Compared with T0,T1,T3 and T4 plasma NT-proBNP and TC levels of the research group were lower（P〈0.05）.MA incidence of the research group was 10.71%（18/168）,and perioperative plasma NT-proBNP and TC levels of MA group were higher than that of non-MA group（P〈0.05）.ROC curve analysis results showed that when the cutoff valued of plasma NT-proBNP and TC level were 728.28 pg/ml and 4.15 mmol/L.the AUC = 0.884（95% CI0.791-0.936）,there was 17 patients with MA on the curve,thus the sensitivity was 94.44%,and there was 148 cases of patients without MA under the curve,thus the specificity was 98.67%,and the accuracy.positive predictive value and negative predictive value were 98.21%,89.47% and 99.33% respectively.Value of plasma NT-proBNP and TC levels of patients w

关 键 词：血浆N端脑利钠肽前体 胆固醇 预测 心脏瓣膜病 恶性心律失常 

分 类 号：R541[医药卫生—心血管疾病]