肝细胞生长因子联合B型钠尿肽对慢性心力衰竭患者中长期死亡事件的预测价值  

Predictive value of HGF combined with BNP in medium-and long-term mortality events in patients with chronic heart failure

作　　者：陈厚良 程小兵[2] 胡泽平[1] Chen Houliang;Cheng Xiaobing;Hu Zeping(Department of Cardiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Province China)

机构地区：[1]安徽医科大学第一附属医院心内科,合肥230022 [2]安徽医科大学合肥第三临床学院心内科

出　　处：《中华老年心脑血管病杂志》2023年第7期696-699,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：安徽高校自然科学研究重大项目(KJ2019ZD65);安徽医科大学科研项目(2021xkj124)。

摘　　要：目的探索肝细胞生长因子(HGF)联合B型钠尿肽(BNP)对慢性心力衰竭(CHF)患者中长期死亡事件的预测价值。方法回顾性分析2015年8月至2017年9月就诊安徽医科大学第一附属医院心内科CHF患者131例,根据随访12、24、36个月不同时间节点全因死亡事件是否发生分为12个月生存组119例和12个月死亡组12例;24个月生存组96例和24个月死亡组35例;36个月生存组89例和36个月死亡组42例,采用ROC曲线评估各指标对12、24、36个月死亡危险因素的预测效能。结果12个月生存组BNP、HGF明显低于12个月死亡组(P<0.05)。24个月生存组年龄、BNP、HGF明显低于24个月死亡组(P<0.05,P<0.01)。36个月生存组BMI明显高于36个月死亡组,BNP、HGF明显低于36个月死亡组(P<0.01)。HGF、BNP是CHF患者随访12个月死亡的独立危险因素(P<0.05),二者联合预测12个月全因死亡的ROC曲线下面积(AUC)为0.786(95%CI:0.676~0.897)。年龄、HGF、BNP是CHF患者随访24个月死亡的独立危险因素(P<0.05,P<0.01),三者联合预测的AUC为0.754(95%CI:0.654~0.854);HGF、BNP、BMI是CHF患者随访36个月死亡的独立危险因素(P<0.05,P<0.01),三者联合预测的AUC为0.748(95%CI:0.704~0.871)。结论HGF、BNP是CHF随访12、24、36个月全因死亡事件的独立危险因素。HGF联合BNP对预测CHF患者中长期死亡事件的价值更高。Objective To explore the predictive value of HGF and BNP in predicting medium-and long-term mortality events in CHF patients.Methods A retrospective trial was carried out in 131 CHF patients admitted to Department of Cardiology of the First Affiliated Hospital of Anhui Medical University from August 2015 to September 2017.According to whether all-cause death events occurred at different time points(12,24 and 36 months)during follow-up period,they were divided into 12-month survival group(n=119)and death group(n=12),24-month survival group(n=96)and death group(n=24),and 36-month survival group(n=89)and death group(n=42).ROC curves were used to evaluate the predictive performance of these mortality risk factors at 12,24,and 36 months in the CHF patients.Results The HGF and BNP levels were significantly lower in the 12-month survival group than the 12-month death group(P<0.05)and in the 24-month survival group than the 24-month death group(P<0.05,P<0.01).The 36-month survival group had obviously higher BMI and lower HGF and BNP levels when compared with the 36-month death group(P<0.01).HGF and BNP were independent risk factors for death in CHF patients after 12 months,and the AUC value of their combination in predicting all-cause death at the time was 0.786(95%CI:0.676-0.897).Age,HGF and BNP were independent risk factors for 24-month death(P<0.05,P<0.01),and the AUC value of the combined 3 indicators was 0.754(95%CI:0.654-0.854).Beside HGF and BNP,BMI was added as another independent risk factor for death in 36 month(P<0.05,P<0.01),and the combined AUC value of HGF,BNP and BMI was 0.748(95%CI:0.704-0.871).Conclusion HGF and BNP are independent risk factors of all-cause mortality in CHF at 12,24 and 36 months'follow-up.HGF combined with BNP shows higher value in predicting the medium-and long-term mortality of CHF patients.

关 键 词：心力衰竭 肝细胞生长因子 利钠肽 脑 预测 

分 类 号：R541.6[医药卫生—心血管疾病]