脑利钠肽水平联合肺动脉CT评估老年心力衰竭患者预后的价值  

Value of brain natriuretic peptide level combined with pulmonary artery CT in evaluating the prognosis of elderly patients with heart failure

作　　者：李娜[1] 曾珉[1] 刘俊宏[1] LI Na;ZENG Min;LIU Junhong(Department of Emergency,Central Hospital,Chenzhou No.1 People's Hospital,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院中心医院急诊科,湖南郴州423000

出　　处：《中国医学物理学杂志》2021年第9期1119-1123,共5页Chinese Journal of Medical Physics

摘　　要：目的:研究脑利钠肽(BNP)水平联合肺动脉电子计算机断层扫描(CT)评估老年心力衰竭(HF)患者预后的价值。方法:选取100例HF患者,根据5年随访的患者生存情况将其分为存活组(n=54)和死亡组(n=46)。检测并比较两组血清BNP水平;回顾肺动脉CT结果,比较右肺动脉直径(RPAD)、室间隔厚度(IVST)、升主动脉直径(AA)、降主动脉直径(PA)、左肺动脉直径(LPAD)以及主肺动脉直径(MPAD)。结果:与死亡组比较,存活组血清BNP水平、RPAD、LPAD显著降低,IVST显著升高,差异有统计学意义(P<0.05);血清BNP水平与RPAD、LPAD呈正相关,与IVST呈负相关,差异均具有统计学意义(P<0.05);与单一指标评估相比,BNP水平联合肺动脉CT评估的灵敏度、特异性、准确度、阳性预测值、阴性预测值、ROC曲线下面积显著升高(P<0.05)。结论:BNP水平联合肺动脉CT评估老年HF患者预后的特异性、灵敏度以及准确度更高,具有较高的临床参考价值。Objective To explore the value of the combination of brain natriuretic peptide(BNP)level and pulmonary artery computed tomography(CT)in evaluating the prognosis of elderly patients with heart failure(HF).Methods A total of 100 HF patients were enrolled and then divided into survival group(n=54)and death group(n=46)according to their survival status during 5-year follow-up.The serum BNP levels were detected and compared between two groups.Pulmonary artery CT examination was also carried out to obtain the right pulmonary artery diameter(RPAD),interventricular septal thickness(IVST),ascending aorta diameter(AA),descending aorta diameter(PA),left pulmonary artery diameter(LPAD)and main pulmonary artery diameter(MPAD).Results Compared with those in death group,the serum BNP level,RPAD and LPAD in survival group were significantly decreased,and IVST was significantly increased,with statistical differences(P<0.05).Serum BNP level was positively correlated with RPAD and LPAD,while it was negatively correlated with IVST,and the differences were statistically significant(P<0.05).Compared with single indicator,the combination of BNP level and pulmonary artery CT for prognosis evaluation had significantly higher sensitivity,specificity,accuracy,positive predictive value,negative predictive value and area under ROC curve(P<0.05).Conclusion BNP level combined with pulmonary artery CT has higher specificity,sensitivity and accuracy in evaluating the prognosis of elderly HF patients,with a higher clinical reference value.

关 键 词：心力衰竭 老年 脑利钠肽 肺动脉 电子计算机断层扫描 

分 类 号：R541.61[医药卫生—心血管疾病]