GDF-15和NT-proBNP联合检测对老年急性心力衰竭患者预后预测价值的研究  

Prognostic value of combined detection of GDF-15 and NT-proBNP in patients with acute heart failure

作　　者：杨德胜 崔国方 YANG Desheng;CUI Guofang(Department of Clinical Laboratroy,Haici Medical Group,Qingdao,Shandong 266033,China;the Second Cardiovascular Department,Haici Medical Group,Qingdao,Shandong 266033,China)

机构地区：[1]山东省青岛市海慈医疗集团检验科,山东青岛266033 [2]山东省青岛市海慈医疗集团心血管二科,山东青岛266033

出　　处：《国际检验医学杂志》2019年第15期1861-1864,共4页International Journal of Laboratory Medicine

摘　　要：目的探讨转化生长因子-15(GDF-15)和N末端B型利钠肽原(NT-proBNP)联合检测在老年急性心力衰竭患者预后预测中的应价值。方法分析2014年2月至2017年2月在该院接诊的165例AHF患者,根据随访结果分为生存组(120例)和死亡组(45例),对患者血清GDF-15和NT-proBNP进行检测。分析两组患者临床资料的差异以及血清GDF-15和NT-proBNP水平对急性心力衰竭患者预后的预测价值。结果生存组与死亡组患者的心功能分级、心率(HR)、左心射血分数(LVEF)、左心室舒张末期内径(LVDD)等资料间差异无统计学意义(P>0.05);生存组GDF-15和NT-proBNP表达水平显著低于死亡组(t=-2.985、-3.912,P=0.004、0.000);ROC曲线显示,应用血清GDF-15和NT-proBNP表达水平预测急性心力衰竭患者预后具有较高的预测效能,其曲线下面积(AUC)分别为0.855和0.847,差异间无统计学意义(P>0.05);血清GDF-15和NT-proBNP联合检测预测急性心力衰竭患者预后的AUC为0.932,明显高于血清GDF-15单独预测(Z=2.958,P=0.003)和血清NT-proBNP单独预测(Z=3.324,P=0.000);约登指数提示血清GDF-15和NT-proBNP预测老年急性心力衰竭患者预后的最佳截点分别为209.54pg/mL和1962.63pg/mL;血清GDF-15和NT-proBNP联合检测急性心力衰竭预后的准确率、灵敏度、特异度、阳性预测值和阴性预测值分别为88.48%、82.22%、90.83%、77.08%和93.16%,灵敏度显著高于各项指标单独诊断(P<0.05)。结论联合检测血清GDF-15和NT-proBNP对急性心肌梗死患者预后预测具有较高的灵敏度,值得临床推广。Objective To investigate the value of combined detection of transforming growth factor-15(GDF-15)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)in predicting the prognosis of patients with acute heart failure(AHF).Methods 165 patients with AHF from February 2014 to February 2017 in our hospital were analyzed.According to the follow-up results,they were divided into survival group(120 cases)and death group(45 cases).The serum GDF-15 and NT-proBNP were detected.The difference of clinical data and the predictive value of serum GDF-15 and NT-proBNP levels in patients with acute heart failure were analyzed.Results There was no significant difference in heart function,heart rate(HR),Left ventricular ejection fraction(LVEF)and Left ventricular end diastolic dimension(LVDD)between the survival group and the death group(P>0.05);the expression levels of GDF-15 and NT-proBNP in the survival group were significantly lower than those in the death group(t=-2.985,-3.912,P=0.004,0.000).ROC curve showed that serum levels of GDF-15 and NT-proBNP were effective in predicting the prognosis of elderly patients with acute heart failure.The AUC of patients with acute heart failure was 0.855 and 0.847,respectively(P>0.05);the combined detection of serum GDF-15 and NT-proBNP predicted the prognosis of patients with acute heart failure was 0.932,significantly higher than that of serum GDF-15(Z=2.958,P=0.003)and serum NT-proBNP individual prediction(Z=3.324,P=0.000);Youden index suggested that the best cut-off points of GDF-15 and NT-proBNP in predicting the prognosis of patients with acute heart failure were≤209.54 pg/mL and≤1 962.63 pg/mL,respectively.The accuracy,sensitivity,specificity,positive predictive value and negative of combined detection of serum GDF-15 and NT-proBNP in predicting the prognosis of patients with acute heart failure were 88.48%,82.22%,90.83%,77.08%and 93.16%,respectively.The sensitivity was significantly higher than that of individual diagnosis(P<0.05).Conclusion Combined detection of serum GDF-15 an

关 键 词：转化生长因子-15 N末端B型利钠肽原 急性心力衰竭 预测预后 

分 类 号：R446.11[医药卫生—诊断学]