HbA1c联合NT-proBNP检测在急性心力衰竭近期死亡风险中的预测作用  

Diagnostic efficacy of HbA1c combined with NT⁃proBNP test for early detection of the risk of near⁃term death in acute heart failure

作　　者：郏红静 丁延魁[1] 高峰[2] 过高峰 JIA Hongjing;DING Yankui;GAO Feng;GUO Gaofeng(Department of Cardiovascular Medicine,the First People’s Hospital of Mengcheng County,Bozhou,Anhui,China,233500;Department of Cardiology,the Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui,China,230071)

机构地区：[1]蒙城县第一人民医院心血管内科,安徽亳州233500 [2]安徽医科大学第二附属医院心内科,安徽合肥230071

出　　处：《分子诊断与治疗杂志》2024年第7期1359-1362,1367,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省科研编制计划项目(2022AH050771)。

摘　　要：目的 探析糖化血红蛋白(HbA1c)联合B型脑钠钛前体生物标志物(NT-proBNP)检测在急性心力衰竭患者近期死亡风险中的预测价值。方法 选取2020年2月至2023年2月蒙城县第一人民医院收治的103例急性心力衰竭患者为观察组,选取同期在本院体检中心体检且各项指标均显示正常的健康者共计101名为对照组。比较不同人群HbA1c、NT-proBNP表达差异;分析HbA1c、NT-proBNP与急性心力衰竭患者近期死亡风险的相关性及诊断价值,并分析影响急性心力衰竭患者死亡的危险因素。结果 观察组血清HbA1c、NT-proBNP表达均显著高于对照组,差异有统计学意义(P<0.05)。观察组HbA1c、NT-proBNP与心功能分级呈正相关(r=0.587,0.536,P<0.05)。死亡组NYAH分级Ⅳ级占比、HbA1c、NT-proBNP表达均高于存活组,差异有统计学意义(P<0.05)。经Logistic回归分析可知,NYAH分级为Ⅳ级、HbA1c及NT-proBNP表达上升是急性心力衰竭患者死亡的危险因素(OR>1,P<0.05)。森林图显示,在与急性心力衰竭患者死亡风险增加的相关因素中,NT-proBNP是关联强度最大的因素(OR=2.491,95%CI 1.414~4.390)。急性心力衰竭死亡患者实施联合检测(HbA1c与NT-proBNP)的AUC值与单独HbA1c、NT-proBNP检测相比更高(P<0.05)。结论 HbA1c、NT-proBNP表达水平随急性心力衰竭死亡患者的心力衰竭严重程度的增加而升高,两指标联合检测可提高预测急性心力衰竭死亡患者的死亡风险效能,可指导临床早期及时干预。Objective To explore the predictive value of HbA1c combined with B-type brain natro-titanium precursor biomarker(NT-proBNP)in the risk of near-term death in patients with acute heart failure.Methods From February 2020 to February 2023,103 patients with acute heart failure admitted to the First People’s Hospital of Mengcheng County were included in the observation group.A total of 101 healthy patients who underwent physical examinations in the physical examination center of our hospital during the same period as the observation group and all indicators showed normal were selected as the control group.The levels of HbA1c and NT-proBNP were compared between the different groups of individuals.The correlation and diag-nostic value between HbA1c,NT proBNP and the risk of recent mortality in patients with acute heart failure were analyzed,along with the risk factors affecting mortality in patients with acute heart failure.Results The levels of serum HbA1c and NT-proBNP in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).HbA1c and NT-proBNP in the obser-vation group showed a positively correlation with cardiac function grade(r=0.587,0.536,P<0.05).The pro-portion of NYAH gradeⅣand the expression of HbA1c and NT-proBNP in the deceased group were higher than those in the surviving group,and the differences were statistically significant(P<0.05).Logistic regres-sion analysis showed that NYAH grade-Ⅳ,HbA1c and the increase of NT-proBNP expression were risk fac-tors for death in patients with acute heart failure(OR>1,P<0.05).The forest plot showed that NT-proBNP was the strongest factor associated with an increased risk of death in patients with acute heart failure(OR=2.491,95%CI 1.414-4.390).The AUC value of combined detection(HbA1c and NT-proBNP)in patients with death from acute heart failure was higher than that of HbA1c and NT-proBNP alone,and the difference was statistically significant(P<0.05).Conclusion The levels of HbA 1 c

关 键 词：急性心力衰竭 HBA1C NT-PROBNP 近期死亡风险 

分 类 号：R541.6[医药卫生—心血管疾病]