慢性心力衰竭患者外周血MR-proADM与NT-proBNP水平变化及其对预后的预测价值  

Changes of the Levels of Peripheral Blood MR-proADM and NT-proBNP in Patients with Chronic Heart Failure and its Predictive Value for Prognosis

作　　者：郝修宏[1] 白智峰[1] HAO Xiu-hong;BAI Zhi-feng(The Second Cardiovascular Department of Internal Medicine,the First People’s Hospital of Shangqiu City,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院心血管内二科,商丘476100

出　　处：《中国合理用药探索》2022年第3期66-70,共5页Chinese Journal of Rational Drug Use

摘　　要：目的:探讨慢性心力衰竭(CHF)患者外周血肾上腺髓质素前体中段肽(MR-pro ADM)与N末端脑钠肽前体(NT-proBNP)的水平变化及其对预后的预测价值。方法:选取2019年3月~2021年2月期间本院收治的96例CHF患者为CHF组,并根据纽约心脏病协会(NYHA)分级进一步分为Ⅱ级(n=40)、Ⅲ级(n=31)和Ⅳ级(n=25)组,另选取50例健康受试者为对照组,测定受试者外周血MR-pro ADM、NT-pro BNP及心功能指标。结果:CHF组血清MR-pro ADM、NT-pro BNP、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)水平均高于对照组,而左室射血分数(LVEF)低于对照组(P<0.05);NYHA分级等级增高,CHF患者的MR-pro ADM、NT-pro BNP、LVESD、LVEDD水平随之升高,LVEF随之下降(P<0.05);Pearson相关性分析结果显示,CHF患者MR-pro ADM、NT-pro BNP与LVESD、LVEDD均分别呈正相关,均与LVEF呈负相关;ROC曲线结果显示,血清MR-pro ADM、NT-pro BNP联合检测预测CHF患者预后的曲线下面积为0.827(95%CI:0.873~0.907),敏感度与特异度分别为85.03%、81.62%。结论:血清MR-proADM、NT-proBNP水平随CHF病情加重而升高,对患者预后具有良好的预测价值,可为CHF临床治疗和预后评估提供参考。Objective: To explore the changes of the levels of peripheral blood mid-regional pro-adrenomedullin(MR-proADM) and N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with chronic heart failure(CHF) and its predictive value for prognosis. Method: A total of 96 patients admitted to our hospital from March 2019 to February 2021 were selected as CHF group, dividing 40 cases in grade Ⅱ group, 31 cases in grade Ⅲgroup, and 25 cases in grade Ⅳ group according to NYHA classification. Another 50 healthy people were selected as the control group. The peripheral blood MR-proADM, NT-proBNP and cardiac function indexes of the patients were determined. Results: The serum MR-proADM, NT-proBNP, LVESD, and LVEDD levels in the CHF group were significantly higher than those in the control group, while the LVEF was lower than that of the control group.As the NYHA grade increased, MR-proADM, NT-proBNP, LVESD and LVEDD of CHF MR-patients increased,while LVEF decreased(P<0.05). Pearson correlation analysis showed that in patients with CHF, proADM and NT-pro BNP were positively correlated with LVESD and LVEDD, but all negatively correlated with LVEF. ROC curve results showed that the combined detection of serum MR-proADM and NT-proBNP predicted the prognosis of CHF patients with AUC of 0.827(95% CI: 0.873~0.907). Sensitivity and specificity degrees were 85.03% and 81.62%, respectively. Conclusion: Serum levels of MR-proADM and NT-proBNP increased with the aggravation of CHF disease, which had a good predictive value for the prognosis of patients, and could provide references for the clinical treatment and prognosis evaluation of CHF.

关 键 词：慢性心力衰竭 肾上腺髓质素前体中段肽 N末端脑钠肽前体 预后 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]