B型利钠肽与血尿素氮对心力衰竭患者预后的联合预测价值  

The combined predictive value of B-type natriuretic peptide and blood urea nitrogen on the prognosis of patients with heart failure

作　　者：陈瑶[1] 徐平[2] 聂臣聪[1] 黄霞 许子寅[2] CHEN Yao;XU Ping;NIE Chencong;HUANG Xia;XU Ziyin(Department of Nursing,Zigong Fourth People's Hospital,Zigong,Sichuan,643000,China;Department of Emergency,Zigong Fourth People's Hospital,Zigong,Sichuan,643000,China)

机构地区：[1]自贡市第四人民医院护理部,四川自贡643000 [2]自贡市第四人民医院急诊科,四川自贡643000

出　　处：《当代医学》2024年第11期76-79,共4页Contemporary Medicine

摘　　要：目的探讨B型利钠肽(BNP)联合血尿素氮(BUN)对心力衰竭(HF)患者预后评估的临床价值。方法回顾性分析2017年1月至2018年12月自贡市第四人民医院收治的1930例HF患者的临床资料。随访6个月,统计患者存活状态。采用单因素分析死亡与存活患者的临床资料;采用Spearman相关性分析单因素分析中差异有统计学意义的指标与HF患者6个月终点事件的关系;采用多因素Logistic回归分析HF患者6个月终点事件的影响因素;绘制ROC,根据AUC预测BUN、BNP及联合检测对HF患者预后的预测价值。结果1930例HF患者存活1874例,死亡56例。死亡患者血肌酐(SCr)、BUN、尿酸、BNP、血清钾水平均高于存活患者,血清钙、血清钠水平均低于存活患者,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,HF患者6个月终点事件与SCr、BUN、尿酸、BNP、血清钙、血清钾和血清钠均呈正相关(r=0.054~0.69,P<0.05),各变量之间也呈正相关,其中SCr与BUN的r为0.69(P<0.05),尿酸与BUN的r为0.57(P<0.05),尿酸与SCr的r为0.59(P<0.05),共线性诊断VIF均<2,其余变量的r均<0.50(P<0.05)。多因素Logistic回归分析结果示,血清BUN、BNP水平高是HF患者6个月发生死亡的独立危险因素(P<0.05)。ROC曲线分析结果显示,BUN预测预后的AUC为0.689,灵敏度为42.902%,特异度为86.203%,最佳截断值为14.495 mmol/L;BNP预测预后的AUC为0.660,灵敏度为62.532%,特异度为66.264%,最佳截断值为1254.500 ng/L;联合预测预后的AUC为0.730,灵敏度为73.172%,特异度为64.601%。结论BNP、BUN对HF患者预后评估均具有临床价值,且联合预测价值优于单独检测。Objective To explore the clinical value of B-type natriuretic peptide(BNP)combined with blood urea nitrogen(BUN)in prognostic evaluation of patients with heart failure.Methods The clinical data of 1930 HF patients admitted to the Zigong Fourth People's Hospital from January 2017 to December 2018 were retrospectively analyzed.After 6 months of follow-up,the survival status of the patients was counted.The clinical data of patients with death and survival were compared by single factor analysis;Spearman correlation analysis was used to analyzed the relationship between the indicators with statistical significance in univariate analysis and the 6 months endpoint events in HF patients;multivariate Logistic regression analysis was used to analyzed the influencing factors of 6 months endpoint events in HF patients;ROC were draw to predict the predictive value of BUN and BNP and combined detection for HF patients'prognosis according to the AUC.Results Of the 1930 HF patients,1874 survived and 56 died.The levels of serum creatinine(SCr),BUN,uric acid,BNP and serum potassium in the death patients were higher than those in the survival patients,and the levels of serum calcium and serum sodium were lower than those in the survival patients,the differences were statistically significant(P<0.05).Spearman correlation analysis results showed,the semiannual endpoint events in HF patients were positively correlated with SCr,BUN,uric acid,BNP,serum calcium,serum potassium and serum sodium(r=0.054-0.69,P<0.05),and among the variables,the r of SCr and BUN was 0.69(P<0.05).The r of uric acid and BUN was 0.57(P<0.05),the r of uric acid and SCr was 0.59(P<0.05),the VIF of collinearity diagnosis was<2,and the r of other variables was<0.50(P<0.05).Multivariate Logistic regression analysis showed that high serum BUN and BNP levels were independent risk factors for death in HF patients for 6 months(P<0.05).ROC curve analysis showed that the AUC of BUN predicting prognosis was 0.689,the sensitivity was 42.902%,the specificity was 86.203%,and

关 键 词：B型利钠肽 血尿素氮 心力衰竭 联合预测 

分 类 号：R541.6[医药卫生—心血管疾病]