抗心力衰竭治疗前后NT-proBNP、PDGF联合Adropin改变率预测预后的效能研究  

Predictive efficacy of NT-proBNP,PDGF,and Adropin change rate before and after anti-heart failure treatment for prognosis

作　　者：刘洋 韩敏 曹雪明 LIU Yang;HAN Min;CAO Xue-ming(Special Ward,Fuwai Central China Cardiovascular Hospital(Heart Center of Henan Provincial People's Hospital),Zhengzhou 450000,Henan,CHINA)

机构地区：[1]阜外华中心血管病医院(河南省人民医院心脏中心)特需病房,河南郑州450000

出　　处：《海南医学》2025年第3期391-395,共5页Hainan Medical Journal

基　　金：2022年河南省医学科技攻关联合共建项目(编号:LHGJ20220104)。

摘　　要：目的研究抗心力衰竭治疗前后N末端B型钠尿肽前体(NT-proBNP)、血小板源性生长因子(PDGF)联合能量平衡相关蛋白(Adropin)改变率对预后的预测效能。方法前瞻性选取2021年9月至2023年6月阜外华中心血管病医院(河南省人民医院心脏中心)收治的259例射血分数下降心力衰竭(HFrEF)患者作为研究对象。所有患者均给予新四联疗法,随访1年,根据预后情况分为良好组214例和不良组45例。比较两组患者的临床资料、治疗前后的NT-proBNP、PDGF、Adropin水平及改变率,采用多因素Logistic回归分析治疗前后NT-proBNP、PDGF、Adropin改变率对预后的影响,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价治疗前后NT-proBNP、PDGF、Adropin改变率对患者预后的预测价值。结果两组患者的临床资料比较差异均无统计学意义(P>0.05);两组患者治疗3个月后和治疗12个月后的NT-proBNP、PDGF、Adropin水平均低于治疗前,且不良组患者治疗3个月后和治疗12个月后的NT-proBNP、PDGF、Adropin水平明显高于良好组,差异均有统计学意义(P<0.05);不良组患者治疗3个月后和治疗12个月后的NT-proBNP、PDGF、Adropin改变率也明显低于良好组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,治疗3个月后NT-proBNP、PDGF、Adropin改变率是抗心力衰竭治疗后预后的影响因素(P<0.05);治疗3个月后NT-proBNP、PDGF、Adropin改变率及联合预测预后的AUC分别为0.761、0.784、0.822、0.927,联合预测效能的AUC明显高于单独预测价值(P<0.05)。结论HFrEF患者血清NT-proBNP、PDGF、Adropin改变率与预后密切相关,且联合预测可用于评估患者的预后。Objective To investigate the predictive efficacy of the change rate of N-terminal pro-B-type natriuretic peptide(NT-proBNP),platelet-derived growth factor(PDGF),and energy balance-associated protein(Adropin)levels for prognosis of patients with heart failure before and after treatment.Methods A total of 259 patients with heart failure with reduced ejection fraction(HFrEF)admitted to Fuwai Central China Cardiovascular Hospital(Heart Center of Henan Provincial People's Hospital)from September 2021 to June 2023 were selected as the research subjects for a prospective study.All patients received the new quadruple therapy and were followed up for one year.Based on prognosis,the patients were divided into a favorable outcome group(n=214)and an adverse outcome group(n=45).Clinical data,as well as the levels and change rates of NT-proBNP,PDGF,and Adropin before and after treatment were compared between the two groups.Multivariate logistic regression analysis was used to investigate the impact of NT-proBNP,PDGF,and Adropin change rate on prognosis before and after treatment.Receiver operating characteristic(ROC)curves and area under the curve(AUC)were used to evaluate the predictive value of the change rate of NT-proBNP,PDGF,and Adropin before and after treatment for prognosis.Results There was no significant difference in clinical data between the two groups(P>0.05).The levels of NT-proBNP,PDGF,and Adropin in both groups of patients after 3 months and 12 months of treatment were lower than those before treatment,and these levels were significantly higher in the adverse outcome group than in the favorable outcome group at both time points(P<0.05).The change rates of NT-proBNP,PDGF,and Adropin in the adverse outcome group after 3 months and 12 months of treatment were also significantly lower than those in the favorable outcome,with statistically significant differences(all P<0.05).The results of the multivariate logistic regression analysis indicated that the change rates in NT-proBNP,PDGF,and Adropin after 3 months of tr

关 键 词：抗心力衰竭 N末端B型钠尿肽前体 血小板源性生长因子 能量平衡相关蛋白 预后 

分 类 号：R541.6[医药卫生—心血管疾病]