NT-proBNP联合ALBI评分对急性失代偿性心力衰竭患者出院后1年内死亡的预测价值  

Predictive Value of NT-proBNP Combined with ALBI Score for Death within One Year after Discharge in Patients with Acute Decompensated Heart Failure

作　　者：陈蒙蒙 李丽[2] 陈良余 CHEN Mengmeng;LI Li;CHEN Liangyu(Department of Internal Medicine,the Affilated Chuzhou Hospital of Anhui Medical University,Chuzhou 239000,China;Department of Cardiovascular Medicine,the Affilated Chuzhou Hospital of Anhui Medical University,Chuzhou 239000,China)

机构地区：[1]安徽医科大学附属滁州医院内科,安徽省滁州市239000 [2]安徽医科大学附属滁州医院心血管内科,安徽省滁州市239000

出　　处：《实用心脑肺血管病杂志》2024年第12期13-16,21,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：安徽省重点研究与开发计划项目(2022e07020058)。

摘　　要：目的分析N末端脑钠肽前体(NT-proBNP)联合白蛋白-胆红素(ALBI)评分对急性失代偿性心力衰竭(ADHF)患者出院后1年内死亡的预测价值。方法回顾性选取安徽医科大学附属滁州医院2021年3月—2023年3月收治的301例ADHF患者,根据出院后1年预后将患者分为死亡组(n=45)和存活组(n=256)。收集患者的临床资料,采用多元Cox比例风险回归分析探讨ADHF患者出院后1年内死亡的影响因素,采用Spearman秩相关分析探讨NTproBNP、ALBI评分与ADHF患者出院后1年内死亡的相关性,绘制ROC曲线以分析NT-proBNP、ALBI评分及二者联合对ADHF患者出院后1年内死亡的预测价值。结果死亡组NT-proBNP、ALBI评分、利尿剂使用率高于存活组,血钠、血尿素氮(BUN)低于存活组(P<0.05)。多元Cox比例风险回归分析结果显示,NT-proBNP〔OR=1.003,95%CI(1.002~1.004)〕、血钠〔OR=0.897,95%CI(0.820~0.981)〕、BUN〔OR=1.182,95%CI(1.052~1.327)〕、ALBI评分〔OR=15.118,95%CI(1.774~128.828)〕、利尿剂使用情况〔OR=3.081,95%CI(1.101~8.618)〕是ADHF患者出院后1年内死亡的独立影响因素(P<0.05)。Spearman秩相关分析结果显示,NT-proBNP、ALBI评分与ADHF患者出院后1年内死亡均呈正相关(P<0.05)。ROC曲线分析结果显示,NT-proBNP、ALBI评分及二者联合预测ADHF患者出院后1年内死亡的曲线下面积(AUC)分别为0.926〔95%CI(0.871~0.981)〕、0.640〔95%CI(0.567~0.713)〕、0.972〔95%CI(0.929~0.999)〕。结论NT-proBNP、ALBI评分是ADHF患者出院后1年内死亡的独立影响因素,且二者联合对ADHF患者出院后1年内死亡的预测价值较高。Objective To analyze the predictive value of N-terminal pro-brain natriuretic peptide(NT-proBNP)combined with albumin-bilirubin(ALBI)score for death within one year after discharge in patients with acute decompensated heart failure(ADHF).Methods A total of 301 ADHF patients admitted to the Affiliated Chuzhou Hospital of Anhui Medical University from March 2021 to March 2023 were retrospectively collected.Patients were divided into the death group(n=45)and the survival group(n=256)based on prognosis at one year after discharge.Clinical data of patients were collected,and multivariate Cox proportional hazard regression analysis was used to investigate the influencing factors of death within one year after discharge in ADHF patients.Spearman rank correlation analysis was conducted to assess the correlation between NT-proBNP,ALBI score and death within one year after discharge in ADHF patients.ROC curve was drawn to analyze the predictive value of NT-proBNP,ALBI score and their combination for death within one year after discharge in ADHF patients.Results The NT-proBNP,ALBI score,and diuretic treatment rate in the death group were higher than those in the survival group,while the blood sodium and blood urea nitrogen(BUN)were lower than those in the survival group(P<0.05).Multivariate Cox proportional hazard regression analysis showed that,NT-proBNP[OR=1.003,95%CI(1.002-1.004)],blood sodium[OR=0.897,95%CI(0.820-0.981)],BUN[OR=1.18295%CI(1.052-1.327)],ALBI score[OR=15.118,95%CI(1.774-128.828)],and diuretic medication[OR=3.081,95%CI(1.101-8.618)]were independent influencing factors of death within one year after discharge in ADHF patients(P<0.05).Spearman rank correlation analysis showed that,NT-proBNP and ALBI score were positively correlated with death within one year after discharge in ADHF patients(P<0.05).ROC curve analysis indicated that,the area under curve(AUC)of NT-proBNP,ALBI score,and their combination for predicting death within one year after discharge in ADHF patients was 0.926[95%CI(0.871-0.981)],0.640[95

关 键 词：心力衰竭 急性失代偿性心力衰竭 N末端脑钠肽前体 白蛋白-胆红素评分 预后 预测 

分 类 号：R541.62[医药卫生—心血管疾病]