血清血管加压素前体在严重失代偿期急性心力衰竭患者死亡预后评估中的价值  

The value of serum copeptin in the prognosis of patients with severe decompensated acute heart failure

作　　者：刘福伍 刘征 李志祥[1] 于大勇[1] LIU Fuwu;LIU Zheng;LI Zhixiang;YU Dayong(Intensive Care Unit,Tangshan Fengrun District People's Hospital,Tangshan Hebei 064000,China)

机构地区：[1]唐山市丰润区人民医院重症医学科,河北唐山064000

出　　处：《中国急救复苏与灾害医学杂志》2021年第3期260-262,274,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省卫生和计划生育委员会医学科学研究重点课题计划项目(编号:20171376)。

摘　　要：目的探讨血清血管加压素前体(copeptin)评估严重失代偿期急性心力衰竭患者死亡预后的价值。方法选取2015年6月-2018年6月唐山市丰润区人民医院收治的438例严重失代偿期急性心力衰竭患者。用酶联免疫吸附实验检测患者入院时血清copeptin水平,根据copeptin水平中位数将患者分为高表达组和低表达组,比较两组患者的临床资料。对所有患者进行为期1年的随访,根据存活情况将患者分为存活组和死亡组,COX回归分析影响患者死亡预后的因素;接收者操作特征曲线(ROC)分析copeptin预测患者死亡预后的价值。结果与低表达组比较,高表达组C反应蛋白(CRP)和B型利钠肽(BNP)水平较高,而左心室射血分数较低,差异有统计学意义(P<0.05)。高表达组患者的死亡率明显高于低表达组(P<0.05)。年龄、CRP、BNP、copeptin和未服用血管紧张素转化酶抑制剂(ACEI)血管紧张素I受体拮抗剂(ARB)药物是严重失代偿期急性心力衰竭患者死亡的影响因素(P<0.05)。血清copeptin预测患者死亡的ROC曲线下面积为0.741,灵敏度为70.65%,特异度为73.33%,约登指数为0.701。结论copeptin对评估严重失代偿期急性心力衰竭患者的死亡预后有较高价值。Objective To explore the value of serum vasopressin precursor(copeptin)in evaluating the prognosis of patients with severe decompensated acute heart failure.Methods From June 2015 to June 2018,438 patients with severe decompensated acute heart failure were selected from our hospital.The level of copeptin was measured by enzy melinked immunosorbent assay.According to the median level of copeptin,the patients were divided into high expression group and low expression group.The clinical data of the two groups were compared.All the patients were followed up for one year.According to the survival condition,the patients were divided into survival group and death group.COX re-gression analysis was used to analyze the factors influencing the death prognosis of the patients.Receiver operating characteristic curve(ROC)was used to analyze the value of copeptin in predicting the death prognosis of the patients.Results Compared with the low expression group,the high expression group had higher levels of C-reactive protein(CRP)and B-type natriuretic peptide(BNP),while the left ventricular ejection fraction was lower(P<0.05).The mortali-ty rate of high expression group was significantly higher than that of low expression group(P<0.05).Age,C-reactive protein(CRP),B-type natriuretic peptide(BNP),copeptin and angiotensin converting enzyme inhibitor(ACEI)/angio-tensinⅡreceptor blockers(ARB)drugs were the influencing factors(P<0.05).Conclusion Copeptin has a high value in evaluating the prognosis of patients with severe decompensated acute heart failure.

关 键 词：血清 血管加压素前体 急性心力衰竭 预后 

分 类 号：R541.61[医药卫生—心血管疾病]