急性心力衰竭患者Ghrelin与NT-proBNP水平的预后预测价值  

Prognostic Value of Ghrelin and NT-proBNP in Patients with Acute Heart Failure

作　　者：邓潮超 朱鹏立[2,3,4] 黄峰 肖华贞[2,3,4] DENG Chaochao;ZHU Pengli;HUANG Feng;XIAO Huazhen(Fujian Provincial Hospital South Branch,Fuzhou 350000,China;不详)

机构地区：[1]福建省立医院南院,福建福州350000 [2]福建省立医院 [3]福建医科大学省立临床医学院 [4]福建省临床老年病研究所

出　　处：《中国医学创新》2021年第14期76-80,共5页Medical Innovation of China

基　　金：福建省科技计划社会发展引导性(重点)项目(2015Y0003)。

摘　　要：目的:研究急性心力衰竭患者胃促生长素(Ghrelin)、氨基端B型利钠肽原前体(NT-proBNP)水平的预后预测价值。方法:选择241例急性心力衰竭患者,测定血浆Ghrelin和NT-proBNP水平,采用电话随访,记录死亡时间。采用Kaplan-Meier曲线做生存分析,采用Cox比例风险回归模型比较组间事件风险比(HR)。结果:所有患者,随访时间0~565 d,中位数时间为151 d。低Ghrelin组和高Ghrelin组年龄、舒张压、钠、肌酐、急性心肌梗死比较,差异均有统计学意义(P<0.05)。高Ghrelin组(Ghrelin>9.19 ng/mL)全因死亡率低于低Ghrelin组(Ghrelin≤9.19 ng/mL)(P<0.05)。高NT-proBNP组(NT-proBNP>3801.0 pg/mL)和低NT-proBNP(NT-proBNP≤3801.0 pg/mL)心率、血红蛋白、钠、肌酐、左心室舒张末期容积、左心室射血分数、冠心病、急性心肌梗死比较,差异均有统计学意义(P<0.05)。高NT-proBNP组全因死亡率高于低NT-proBNP组(P<0.01)。Kaplan-Meier曲线显示,高Ghrelin组的中位生存时间长于低Ghrelin组(P<0.01),低NT-proBNP组的中位生存时间长于高NT-proBNP组(P<0.05)。Cox比例风险模型分析显示,低Ghrelin高NT-proBNP组发生死亡事件风险为高Ghrelin低NT-proBNP组5.346倍[95%CI(1.461,19.561),P<0.01]。结论:低Ghrelin、高NT-proBNP水平的急性心力衰竭患者预后差。Objective:To study prognostic value of Ghrelin and NT-proBNP in patients with acute heart failure.Method:Clinical data of 241 patients with acute heart failure were collected,plasma Ghrelin and NT-proBNP levels were determined,telephone follow-up was performed,and time of death was recorded.Kaplan-Meier curve was used for survival analysis,and Cox proportional risk regression model was used to compare the inter-group event risk ratio(HR).Result:All patients were followed up for 0-565 d,with a median of 151 d.There were statistically significant differences in age,diastolic blood pressure,sodium,creatinine and acute myocardial infarction between the low and high Ghrelin group(P<0.05).All-cause mortality rate of high Ghrelin group(Ghrelin>9.19 ng/mL)was lower than that of low Ghrelin group(Ghrelin≤9.19 ng/mL)(P<0.05).There were significant differences between the high NT-proBNP(NT-proBNP>3801.0 pg/mL)group and the low NT-proBNP(NT-proBNP≤3801.0 pg/mL)in heart rate,hemoglobin,sodium,creatinine,left ventricular end-diastolic volume,left ventricular ejection fraction,coronary heart disease,and acute myocardial infarction(P<0.05).All-cause mortality rate of high NT-proBNP group was higher than that of low NT-proBNP group(P<0.01).Kaplan-Meier survival curve showed that the median survival time of high Ghrelin group was higher than that of low Ghrelin group(P<0.01).The median survival time of low NT-proBNP group was higher than that of high NT-proBNP group(P<0.05).Cox proportional hazards model analysis showed that,the death occurred HR of the low Ghrelin and high NT-proBNP group compared with the high Ghrelin and low NT-proBNP group was 5.346[95%CI(1.461,19.561),P<0.01].Conclusion:The low Ghrelin level and high NT-proBNP level have poor outcome in patients with acute heart failure.

关 键 词：急性心力衰竭 GHRELIN NT-PROBNP 预后 

分 类 号：R541.6[医药卫生—心血管疾病]