氨基末端B型钠尿肽原及心型脂肪酸结合蛋白水平与心力衰竭患者预后关系分析  

Correlation between N-terminal pro-B-type natriuretic peptide,heart type fatty acid binding protein and prognosis of patients with heart failure

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作  者:王俊[1] 赵丹[1] 李娜[1] 陈扬波[1] Wang Jun;Zhao Dan;Li Na;Chen Yangbo(Second Department of Critical Care Medicine,Tongde Hospital,Hangzhou 330009,Zhejiang Province,China)

机构地区:[1]浙江省立同德医院重症医学二科,杭州330009

出  处:《中国基层医药》2021年第4期543-547,共5页Chinese Journal of Primary Medicine and Pharmacy

摘  要:目的:探讨氨基末端B型钠尿肽原(NT-proBNP)及心型脂肪酸结合蛋白(H-FABP)水平与心力衰竭患者预后的关系。方法:选取2017年12月至2019年6月浙江省立同德医院收治的老年重症心力衰竭患者49例为观察组,选取同期在该院体检的健康者49例为对照组。检测比较观察组不同纽约心脏病协会(NYHA)分级及对照组的NT-proBNP、H-FABP水平,分析两项指标对心力衰竭患者的诊断价值及其与预后的关系。结果:观察组的NT-proBNP、H-FABP水平分别为(341.52±12.74)pg/mL、(69.01±11.45)ng/mL,均明显高于对照组的(189.60±12.73)pg/mL、(37.25±11.44)ng/mL,差异均有统计学意义(t=59.047、13.735,均P<0.001);观察组NYHAⅢ级患者的NT-proBNP、H-FABP水平分别为(295.62±42.38)pg/mL、(75.09±19.15)ng/mL,均明显高于NYHAⅠ级患者的(120.43±21.69)pg/mL、(21.76±5.22)ng/mL、Ⅱ级患者的(203.51±42.77)pg/mL、(44.92±10.85)ng/mL,差异均有统计学意义(F=55.100、46.040,均P<0.001);NYHAⅠ级患者的NT-proBNP、H-FABP水平均明显低于NYHAⅡ的级患者(t=7.231、8.130,均P<0.001);且NT-proBNP、H-FABP单独检测对心力衰竭诊断的敏感度、准确度分别为76.92%、78.85%、84.69%、86.73%,均明显低于两者联合检测的98.08%、97.96%,差异均有统计学意义(χ^(2)=75.760、10.913,均P<0.05);NT-proBNP、H-FABP水平与患者的预后状况呈正相关(r=0.362、0.611,均P<0.05)。结论:NT-proBNP、H-FAB水平与老年重症心力衰竭患者的预后呈正相关,其联合检测能提高重症心力衰竭的诊断敏感度和准确度。Objective To correlate N-terminal pro-B-type natriuretic peptide(NT-proBNP)and heart type fatty acid binding protein(H-FABP)levels with the prognosis of patients with heart failure.Methods Forty-nine patients with severe heart failure who received treatment in Tongde Hospital from December 2017 to June 2019 were included in the observation group.Forty-nine healthy subjects who concurrently received health examination were included in the control group.The heart function of the 49 patients was graded by the New York Heat Association(NYHA)classification.The levels of NT-proBNP and H-FABP were measured in different NYHA grades of patients and the healthy controls.The value of NT-proBNP and H-FABP levels in the diagnosis of heart failure was investigated and NT-proBNP and H-FABP levels were correlated with prognosis of heart failure.Results In the observation group,NT-proBNP and H-FABP levels were(341.52±12.74)pg/mL and(69.01±11.45)ng/mL,respectively,which were significantly higher than(189.60±12.73)pg/mL and(37.25±11.44)ng/mL,respectively,in the control group(t=59.047 and 13.735,both P<0.001).In patients with NYHA III grade severe heart failure,NT-proBNP and H-FABP levels were(295.62±42.38)pg/mL and(75.09±19.15)ng/mL,respectively,which were significantly higher than(120.43±21.69)pg/mL and(21.76±5.22)ng/mL,respectively in patients with NYHA I grade severe heart failure,(203.51±42.77)pg/mL and(44.92±10.85)ng/mL in patients with NYHAⅡgrade severe heart failure(F=55.100,46.040,both P<0.001).NT-proBNP and H-FABP levels in patients with NYHA I grade severe heart failure were significantly lower than those in patients with NYHAⅡgrade severe heart failure(t=7.231,8.130,both P<0.001).The sensitivity and accuracy of detecting NT-proBNP and H-FABP levels alone in the diagnosis of heart failure(76.92%,78.85%,84.69%,86.73%)were significantly lower than those of detecting NT-proBNP and H-FABP levels in combination(98.08%,97.96%,χ^(2)=75.760,10.913,both P<0.001).NT-proBNP and H-FABP levels were positively correlated

关 键 词:心力衰竭 氨基末端B型钠尿肽原 心型脂肪酸结合蛋白 预后 敏感度 准确度 老年人 

分 类 号:R541.6[医药卫生—心血管疾病]

 

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