血清糖类抗原199联合N末端B型利钠肽原对急性脑梗死并发脑心综合征的预测价值  

Predictive value of serum carbohydrate antigen 199 combined with N-terminal B-type natriuretic peptide in patients with acute cerebral infarction complicated with cerebral-cardiac syndrome

作　　者：胡春影 冯敏[1] HU Chunying;FENG Min(The Second Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第二附属医院,安徽蚌埠233000

出　　处：《中国实用神经疾病杂志》2023年第10期1211-1215,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：目的分析血清糖类抗原199(CA199)及N末端B型利钠肽原(NT-proBNP)对急性脑梗死并发脑心综合征的预测价值。方法选取2021-03—2023-03于蚌埠医学院第二附属医院就诊的106例急性脑梗死患者为对象,根据住院7 d内是否发生脑心综合征分为脑心综合征(CCS)组(n=44)及无CCS组(n=62)。所有患者均于入院后24 h内检测血糖、胆固醇、血肌酐、肌酸激酶同工酶(CK-MB)、左心室射血分数(LVEF)、CA199及NT-proBNP。采用受试者工作特征(ROC)曲线评估血清CA199及NT-proBNP水平对急性脑梗死并发脑心综合征的预测效能,采用Logistic回归分析急性脑梗死并发脑心综合征的危险因素。结果CCS组患者平均年龄、血肌酐及CK-MB水平显著高于无CCS组(P<0.05),LVEF显著低于无CCS组(P<0.001)。CCS组患者CA199水平(28.29±3.01)U/mL,NT-proBNP水平(614.03±107.81)ng/L,无CCS组患者CA199水平(21.01±2.58)U/mL,NT-proBNP水平(280.63±39.71)ng/L,CCS组患者血清CA199及NT-proBNP水平均显著高于无CCS组(P<0.001)。Logistic回归分析显示LVEF、CA199及NT-proBNP均为急性脑梗死并发脑心综合征的独立危险因素(LVEF:β=—0.564,P=0.045,OR=0.842,95%CI=0.701~0.915;CA199:β=0.605,P=0.038,OR=2.166,95%CI=1.078~4.226;NT-proBNP:β=0.739,P=0.011,OR=2.098,95%CI=1.163~4.185)。ROC曲线分析显示血清CA199及NT-proBNP联合预测急性脑梗死并发脑心综合征的曲线下面积为0.842(P<0.001),灵敏度83.87%,特异度81.82%。结论血清CA199及NT-proBNP联合检测对急性脑梗死并发脑心综合征具有较高的预测价值。Objective To analyze the predictive value of serum carbohydrate antigen 199(CA199)and N-terminal B-type natriuretic peptide(NT-proBNP)in acute cerebral infarction complicated with cerebral-cardiac syndrome.Methods A total of 106 patients with acute cerebral infarction who were admitted to the Second Affiliated Hospital of Bengbu Medical College from March 2020 to March 2023 were selected as the objects.According to the incidence of cerebral-cardiac syndrome within 7 d of hospitalization,they were divided into cerebral-cardiac syndrome(CCS)group(n=44)and non-CCS group(n=62).Blood glucose,cholesterol,creatinine,creatine kinase isoenzyme(CK-MB),left ventricular ejection fraction(LVEF),CA199,and NT-proBNP were measured in all patients after admission.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of serum CA199 and NT-proBNP levels for acute cerebral infarction complicated with cerebral-cardiac syndrome.Logistic regression analysis was used to investigate the risk factors for acute cerebral infarction complicated with cerebral-cardiac syndrome.Results The mean age,serum creatinine,and CK-MB levels in CCS group were significantly higher than those in non-CCS group(P<0.05).LVEF in CCS group was significantly lower than that in non-CCS group(P<0.001).The level of CA199 in CCS group was(28.29±3.01)U/mL,and the level of NT-proBNP was(614.03±107.81)ng/L.The level of CA199 in non-CCS group was(21.01±2.58)U/mL,and the level of NT-proBNP was(280.63±39.71)ng/L.The levels of serum CA199 and NT-proBNP in CCS group were significantly higher than those in non-CCS group(P<0.001).Logistic regression analysis showed that LVEF,CA199,and NT-proBNP were independent risk factors for acute cerebral infarction complicated with cerebral-cardiac syndrome(LVEF:β=—0.564,P=0.045,OR=0.842,95%CI=0.701—0.915;CA199:β=0.605,P=0.038,OR=2.166,95%CI=1.078—4.226;NT-proBNP:β=0.739,P=0.011,OR=2.098,95%CI=1.163—4.185).ROC curve analysis showed that the area under the curve of CA199 combined with NT-p

关 键 词：脑梗死 脑心综合征 糖类抗原199 N末端B型利钠肽原 预测价值 

分 类 号：R743.33[医药卫生—神经病学与精神病学]