血清肌钙蛋白、超敏C反应蛋白及N端前体脑钠肽在急性心肌梗死合并心力衰竭患者预后中的预测价值  

Prognostic Value of Serum Troponin,Hypersensitive C-reactive Protein and N-terminal Precursor Brain Natriuretic Peptide in Patients with Acute Myocardial Infarction Complicated with Heart Failure

作　　者：吴星辰 成雅 苏莹莹 WU Xingchen;CHENG Ya;SU Yingying(Department of Cardiology,Xinyi Hospital of Traditional Chinese Medicine,Xinyi 221400,Jiangsu,China)

机构地区：[1]新沂市中医医院心病一科,江苏新沂221400

出　　处：《系统医学》2024年第18期96-99,共4页Systems Medicine

摘　　要：目的分析血清肌钙蛋白I(cardiac troponin I,cTnI)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)及N端前体脑钠肽(N-terminal pro brain natriuretic peptide,NT⁃proBNP)在急性心肌梗死(acute myo⁃cardial infarction,AMI)合并心力衰竭(heart failure,HF)患者中的表达对预后的预测价值。方法回顾性选取2021年1月—2023年8月新沂市中医医院收治的AMI合并HF患者71例的临床资料,根据患者是否出现主要不良心血管事件分为预后良好组(40例)与预后不良组(31例),比较两组患者临床资料及cTnI、hs-CRP、NT⁃proBNP的表达水平,采用多因素Logistic回归分析其独立危险因素,采用受试者工作特征曲线的评估cTnI、hs-CRP、NT⁃proBNP对AMI合并HF患者预后的预测价值。结果预后良好组患者血清cTnI、hs-CRP、NT⁃proBNP值均低于预后不良组,差异有统计学意义(P均<0.05);多因素Logistic回归分析表明,NT⁃proBNP、hs-CRP、cTnI水平升高是AMI合并HF患者预后不良的独立危险因素(P均<0.05);cTnI、hs-CRP、NT⁃proBNP对心肌梗死合并心衰患者不良预后的曲线下面积分别为0.798、0.783、0.728,联合检测的曲线下面积为0.918。结论AMI合并HF患者血清cTnI、hs-CRP和NT-proBNP水平是影响患者预后的独立预测因素,这些指标对患者的预后评估具有较为重要的临床价值。Objective To analyze the prognostic value of serum cardiac troponin I(cTnI),hypersensitive C-reactive protein(hs-CRP)and N-terminal pro brain natriuretic peptide(NT-proBNP)in patients with acute myocardial infarction(AMI)complicated with heart failure(HF).Methods The clinal data of seventy-one patients with AMI combined with HF admitted to Xinyi Hospital of Traditional Chinese Medicine from January 2021 to August 2023 were retrospectively selected and divided into good prognosis group(forty cases)and poor prognosis group(thirty-one cases)based on whether the patient had major adverse cardiovascular events.Clinical data and expression levels of cTnI,hs-CRP and NTproBNP were compared between the two groups.Multivariate Logistic regression was used to analyze the independent risk factors,and the predictive value of cTnI,hs-CRP,NTproBNP on the prognosis of AMI patients complicated with HF was evaluated by the work characteristic curve of subjects.Results Serum cTnI,hs-CRP,NTproBNP values of patients with good prognosis group were lower than those of patients with poor prognosis group(all P<0.05).Multivariate Logistic regression analysis showed that NT-proBNP,hs-CRP and cTnI were independent risk factors for poor prognosis in patients with AMI complicated with HF(all P<0.05).The area under the curve of cTnI,hs CRP,NTproBNP on adverse prognosis of patients with myocardial infarction combined with heart failure were 0.798,0.783,0.728,respectively,and the rea under the curve of combined detection was 0.918.Conclusion The levels of serum cTnI,hs-CRP and NT-proBNP in patients with AMI complicated with HF are independent predictors of prognosis.These indicators have important clinical value for the prognosis of patients.

关 键 词：血清肌钙蛋白 超敏C反应蛋白 N端前体脑钠肽 急性心肌梗死 心力衰竭 

分 类 号：R54[医药卫生—心血管疾病]