NT-proBNP是预测心肌梗死后心力衰竭的重要指标  

NT-proBNP Is an Important Indicator for Predicting Heart Failure after Acute Myocardial Infarction

作　　者：刘锐锋 高翔宇[1] 范继红 赵慧强[1] LIU Ruifeng;GAO Xiangyu;FAN Jihong(Department of Cardiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院心血管中心,100050

出　　处：《医学研究杂志》2025年第2期172-176,187,共6页Journal of Medical Research

基　　金：首都医科大学附属北京友谊医院科研启动基金资助项目(ZX2020-2)。

摘　　要：目的探讨住院期间N末端脑钠肽前体(N-terminal pro-B-type natriuretic peptide,NT-proBNP)峰值水平与急性心肌梗死(acute myocardial infarction,AMI)患者恢复期左心室射血分数(left ventricular ejection fraction,LVEF)<50%风险的关系。方法采用回顾性病例对照研究方法,选取2018年1月~2023年12月首都医科大学附属北京友谊医院收治的220例AMI患者,按照住院期间NT-proBNP峰值水平的三分位数分为3组。收集患者的基线临床特征、实验室检查结果和NT-proBNP峰值等,主要结局为AMI恢复期是否LVEF<50%。通过纳入混杂因素构建3个逐步复杂的Logistic回归模型和线性回归模型来分析NT-proBNP峰值与LVEF<50%风险的关系,并使用限制性立方样条(restricted cubic spline,RCS)探讨两者之间的非线性关系。结果NT-proBNP峰值水平与恢复期LVEF<50%风险增加呈正相关,即使调整混杂因素后仍存在。RCS分析揭示了两者的非线性关系。NT-proBNP峰值在1822.991pg/ml时预测LVEF<50%的敏感度为57.14%,特异性为70.97%。结论NT-proBNP峰值为1822.991pg/ml是预测AMI患者恢复期LVEF<50%的有用指标,其可用于识别高危AMI人群,为行早期积极干预提供依据。Objective To investigate the relationship between the peak levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP)during hospitalization and the risk of left ventricular ejection fraction(LVEF)<50%during the recovery period in patients with acute myocardial infarction(AMI).Methods This retrospective cohort study included 220 AMI patients treated at Beijing Friendship Hospital,Capital Medical University from January 2018 to December 2023.The patients were divided into three groups according to the tripartite value of peak levels of NT-proBNP during hospitalization.Baseline clinical characteristics,laboratory test results,and peak levels of NT-proBNP were collected.The primary outcome was LVEF<50%during the recovery period.By incorporating confounding factors,three stepwise complex Logistic regression model and linear regression model were used to analyze the relationship between peak levels of NT-proBNP and the risk of LVEF<50%.Restricted cubic spline(RCS)was used to explore the nonlinear relationship between them.Results The peak levels of NT-proBNP were positively correlated with an increased risk of LVEF<50%during the recovery period,even after adjusting for confounding factors.RCS analysis revealed the nonlinear relationships between them.When the peak levels of NT-proBNP was 1822.991pg/ml,the sensitivity and specificity of predicting LVEF<50%were 57.14%and 70.97%.Conclusion The NT-proBNP peak levels of 1822.991pg/ml is a useful indicator for predicting LVEF<50%in AMI patients during the recovery period,and it can be used to identify high-risk AMI groups and provide basis for early active intervention.

关 键 词：N末端脑钠肽前体 急性心肌梗死 左心室射血分数 限制性立方样条 

分 类 号：R54[医药卫生—心血管疾病]