血清POSTN、NT-proBNP水平与扩张型心肌病伴心力衰竭患者短期预后的关系  

Relationship between serum POSTN and NT-proBNP levels and short-term prognosis in patients with dilated cardiomyopathy and heart failure

作　　者：赵德全 赵双凤 黄丽君 Zhao Dequan;Zhao Shuangfeng;Huang Lijun(Department of Cardiovascular Medicine,Zhengzhou Third People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第三人民医院心血管内科,河南郑州450000

出　　处：《齐齐哈尔医学院学报》2024年第19期1813-1817,共5页Journal of Qiqihar Medical University

摘　　要：目的探讨血清骨膜蛋白(POSTN)、N-末端B型利钠肽(NT-proBNP)水平与扩张型心肌病(DCM)伴心力衰竭(HF)患者短期预后的关系。方法回顾性分析2021年7月—2023年7月本院收治的157例DCM伴HF患者的临床资料,均完成6个月随访,收集患者入院时一般资料及血清POSTN、NT-proBNP水平,并将随访期间主要不良心血管事件发生情况作为预后情况评估标准,根据其发生情况分为预后良好组(n=124)和预后不良组(n=33)两组,分析血清POSTN、NT-proBNP水平对DCM伴HF患者短期预后的预测价值。结果Ⅳ级患者血清POSTN、NT-proBNP水平均高于Ⅱ级、Ⅲ级,且Ⅲ级患者血清POSTN、NT-proBNP水平均高于Ⅱ级(P<0.05);预后不良组NYHA心功能分级、血清POSTN、NT-proBNP水平均高于预后良好组(P<0.05);两组间性别、年龄、体重指数、基础疾病、收缩压、舒张压、心率、吸烟史、饮酒史、用药情况及白细胞计数、血红蛋白、总胆固醇、三酰甘油、空腹血糖、乳酸脱氢酶、磷酸肌酸激酶、磷酸肌酸激酶同工酶水平比较,差异无统计学意义(P>0.05);经Logistic回归分析,NYHA心功能分级、血清POSTN、NT-proBNP水平升高是DCM伴HF患者短期预后不良的危险因素(OR>1,P<0.05);绘制ROC曲线,结果显示,血清POSTN、NT-proBNP水平单独及联合预测DCM伴HF患者短期预后的AUC分别为0.801、0.796、0.863,均具有一定预测价值,且联合预测价值较高。结论血清POSTN、NT-proBNP水平是DCM伴HF患者短期预后不良的影响因素,且其水平对DCM伴HF患者短期预后情况具有一定预测价值。Objective To investigate the relationship between serum levels of periostin(POSTN)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)and the short-term prognosis of patients with dilated cardiomyopathy(DCM)complicated by heart failure(HF).Methods Clinical data of 157 patients with DCM and HF admitted to our hospital from July 2021 to July 2023 were retrospectively analyzed.All patients completed a 6-month follow-up.General patient information and serum POSTN and NT-proBNP levels at admission were collected.The occurrence of major adverse cardiovascular events(MACCE)during the follow-up period served as the standard for assessing prognosis,dividing patients into a good prognosis group(n=124)and a poor prognosis group(n=33).The predictive value of serum POSTN and NT-proBNP levels for the short-term prognosis of DCM patients with HF was analyzed.Results Serum POSTN and NT-proBNP levels were higher in patients with NYHA classⅣcompared to classesⅡandⅢ,and levels in classⅢwere higher than in classⅡ(P<0.05).In the poor prognosis group,NYHA cardiac function class,serum POSTN,and NT-proBNP levels were higher than in the good prognosis group(P<0.05).There were no significant differences in gender,age,body mass index,underlying diseases,systolic and diastolic blood pressure,heart rate,smoking and drinking history,medication use,white blood cell count,hemoglobin,total cholesterol,triglycerides,fasting blood sugar,lactate dehydrogenase,creatine kinase,and creatine kinase isoenzyme levels between the two groups(P>0.05).Logistic regression analysis indicated that a higher NYHA cardiac function class and elevated serum POSTN and NT-proBNP levels were risk factors for poor short-term prognosis in DCM patients with HF(OR>1,P<0.05).The area under the receiver operating characteristic(ROC)curve for serum POSTN and NT-proBNP levels alone and in combination to predict the short-term prognosis of DCM patients with HF were 0.801,0.796,and 0.863,respectively,indicating a certain predictive value,with the combined predictio

关 键 词：扩张型心肌病 心力衰竭 骨膜蛋白 N-末端前体B型利钠肽 短期预后 

分 类 号：R542.2[医药卫生—心血管疾病]