BNP、Scr、S-100β蛋白及CysC对体外循环心脏手术患者预后的影响  

Effects of BNP,Scr,S-100β and CysC on the prognosis of patients undergoing cardiopulmonary bypass

作　　者：于洪波 马大实[1] 王宝刚[1] 马春野[1] YU Hongbo;MA Dashi;WANG Baogang(Department of Cardiac Surgery,The First Hospital of Jilin University,Jilin,Changchun 130000,China)

机构地区：[1]吉林大学第一医院,长春市130000

出　　处：《河北医药》2019年第8期1125-1129,1135,共6页Hebei Medical Journal

基　　金：吉林省科技厅科技发展计划项目(编号:20160520148JH);吉林省卫生厅青年基金项目(编号:2017Q018);吉林省中医药科技项目(编号:2017244)

摘　　要：目的探讨脑钠肽(brain natriuretic peptide,BNP)、血清肌酐(serum creatinine,Scr)、S-100β蛋白及胱抑素C(cystatin C,CysC)对体外循环心脏手术预后的影响。方法选取2014年1月1日至2016年1月1日胸外科胸外科诊断为心力衰竭并接受体外循环(extracorporeal circulation,ECC)心脏手术的130例患者为研究对象,自出院后1周进行为期2年的随访。根据随访结果,将患者分预后良好组和预后不良组,运用Kaplan-Meier生存曲线分析体外循环心脏手术患者生存状态;单因素、多因素COX比例风险回归模型分析可能影响ECC心脏手术预后的因素;绘制ROC曲线比较各因素的敏感性及特异性。结果多因素COX比例风险回归模型分析显示S-100β(P=0.025)、Scr(P=0.015)、BNP(P=0.047)、CysC(P=0.008)、LVEF(P=0.037)可影响ECC心脏手术患者预后;CysC联合BNP的ACU为0.846,其敏感性、特异性分别为81.3%,79.05%。结论 S-100β、Scr、BNP、CysC,LVEF是ECC心脏手术预后的影响因素,CysC联合BNP诊断可作为ECC心脏手术的辅助预测指标,具有潜在临床应用价值。Objective To explore the effects of brain natriuretic peptide(BNP),serum creatinine (Scr),S-100β protein and Cystatin C(CysC) on the prognosis of patients undergoing cardiopulmonary bypass. Methods A total of 130 patients with heart failure who received extracorporeal circulation (ECC) cardiac surgery in our hospital from January 1,2014 to January 1,2016 were enrolled in the study. These patients were followed up for two years after being discharged from hospital for a week.According to the follow up results,the patients were divided into good prognosis group and poor prognosis group.The survival state of patients was analyzed by Kaplan-Meier survival curve,and the sensitivity and specificity of different factors were analyzed and compared by single factor and multi factor COX proportional hazards regression model. Results The multi factor COX proportional hazards regression results showed that S-100β,Scr,BNP,CysC,LVEF might affect the prognosis of ECC patients undergoing cardiac surgery ( P <0.05 or P <0.01).According to the ACU value of CysCcombined with BNP was 0.846,its sensitivity and specificity were 81.3%,79.05%,respectively. Conclusion S-100β,Scr,BNP,CysC and LVEF are the influencing factors of ECC cardiac surgery.CysC combined with BNP diagnosis can be regarded as an auxiliary predictive index for cardiac surgery,which has potential clinical application value.

关 键 词：心脏手术 体外循环 脑钠肽 血肌酐 S-100Β蛋白 胱抑素C 

分 类 号：R654.2[医药卫生—外科学]