FT3/FT4、hs-CRP/PA、NT-proBNP水平对预测老年急性心力衰竭患者预后的价值  

Value of FT3/FT4,hs-CRP/PA and NT-proBNP in predicting poor prognosis in elderly AHF patients

作　　者：姜帆[1] 周泓屹 王飞跃 陈东升 吴广明[1] Jiang Fan;Zhou Hongyi;Wang Feiyue;Chen Dongsheng;Wu Guangming(Department of General Medicine,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China;Department of Anesthesiology,Tongzhou District Maternal and Child Health Care Hospital,Beijing 101100,China)

机构地区：[1]首都医科大学附属北京潞河医院全科医学科,北京101149 [2]北京市通州区妇幼保健院麻醉科,北京101100

出　　处：《兰州大学学报（医学版）》2024年第7期22-27,共6页Journal of Lanzhou University（Medical Sciences）

基　　金：首都全科医学与社区卫生研究专项资助项目(首发2023-2Y-014)。

摘　　要：目的 探究游离三碘甲状腺原氨酸/甲状腺素(FT3/FT4)、超敏C反应蛋白/前清蛋白(hs-CRP/PA),及氨基末端脑钠肽前体(NT-proBNP)对老年急性心力衰竭(AHF)预后不良的预测价值。方法 选取2022年3月—2023年3月首都医科大学附属北京潞河医院收治的72例老年AHF患者作为研究组,收集患者FT3/FT4、hs-CRP/PA,及NT-proBNP等临床资料及入院随访一年预后情况,根据预后情况分为预后不良组(n=23)和预后良好组(n=49);另随机抽取72例健康志愿者作为对照组,分析其临床资料及NT-proBNP、FT3/FT4、hs-CRP/PA水平差异,分析其对老年AHF的预测价值。结果 研究组患者的FT3/FT4低于对照组患者,hs-CRP/PA及NT-proBNP高于对照组患者(P<0.05);预后不良组患者FT3/FT4低于预后良好组患者,hs-CRP/PA及NT-proBNP水平高于预后良好组患者(P<0.05)。多因素Logistic回归分析结果显示NT-proBNP、FT3/FT4、hs-CRP/PA水平均为患者预后不良的影响因素(P<0.05)。受试者操作特征曲线分析结果显示,NT-proBNP、FT3/FT4、hs-CRP/PA水平预测老年AHF患者的曲线下面积分别为0.816、0.862、0.713。结论 NT-proBNP、FT3/FT4、hs-CRP/PA与老年AHF患者不良预后有关,3项指标共同使用预测患者预后效能良好。Objective To explore the predictive value of free triiodothyronine/thyroxine(FT3/FT4),hypersensitive C-reactive protein/prealbumin(hs-CRP/PA)and amino-terminal brain natridium peptide precursor(NTproBNP)in poor prognosis in elderly acute heart failure(AHF).Methods A total of 72 elderly AHF patients who were admitted to Beijing Luhe Hospital,Capital Medical University from March 2022 to March 2023 were selected.The clinical data including levels of FT3/FT4,hs-CRP/PA,and NT-proBNP levels were collected,and the patients were followed up for one-year after admission to evaluate their prognosis,based on which patients were divided into a poor prognosis group(n=23)and good prognosis group(n=49).Additionally,72 healthy volunteers were randomly selected as the control group.Clinical data and the levels of NT-proBNP,FT3/FT4,and hs-CRP/PA were analyzed to assess their predictive value for elderly AHF.Results Patients in the study group had lower FT3/FT4 levels than the control,the levels of hs-CRP/PA and NT-proBNP were higher than the control(P<0.05),FT3/FT4 levels were lower in the poor prognosis group than in the good group.The levels of hs-CRP/PA and NT-proBNP were higher than those in the good prognosis group(P<0.05).Multivariable Logistic regression analysis showed that levels of NT-proBNP,FT3/FT4,and hs-CRP/PA were influencing factors for poor prognosis in patients(P<0.05).The receiver operator characteristic curve analysis showed that the area under the curve of NT-proBNP,FT3/FT4,and hs-CRP/PA for predicting elderly AHF patients was 0.816,0.862,and 0.713,respectively.Conclusion NT-proBNP,FT3/FT4 and hs-CRP/PA levels are related to poor prognosis in elderly AHF patients,and a combination of the three indicators yields greater predictive efficacy for the prognosis of these patients.

关 键 词：游离三碘甲状腺原氨酸/甲状腺素 超敏C反应蛋白/前清蛋白 氨基末端脑钠肽前体 老年急性心力衰竭 预后 

分 类 号：R541.6[医药卫生—心血管疾病]