血清NT-proBNP及D-D联合AngⅡ对高血压合并心力衰竭患者MACE风险的预测效能分析  

Efficacy of serum NT-proBNP and D-D combined with AngⅡin predicting major adverse cardiovascular events risk in hypertensive patients with heart failure

作　　者：陈海鹏[1] 王宝莹 蓝帆 CHEN Hai-peng;WANG Bao-ying;LAN Fan(Department of Cardiology,the Third Peoples Hospital of Luohe,Luohe,Henan 462000,China)

机构地区：[1]漯河市第三人民医院心内科,河南漯河462000

出　　处：《医药论坛杂志》2025年第5期471-475,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190089)。

摘　　要：目的探讨血清N末端B型利钠肽前体(N-terminal B-type natriuretic peptide precursors,NT-proBNP)及D二聚体(D-dimer,D-D)联合血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)对高血压合并心力衰竭病患主要不良心血管事件(major adverse cardiovascular events,MACE)风险的预测效能。方法将漯河市第三人民医院2018年3月—2023年3月收治的84例高血压合并心力衰竭病例作为调查目标,根据病例出院6个月内是否发生MACE将84例病例划入对照组(未发生MACE,n=62)及观察组(发生MACE,n=22)。分析两组的一般资料及血清NT-proBNP、D-D及AngⅡ丰度差异,采用二元logistic回归分析探究高血压合并心力衰竭病患发生MACE的独立影响因素,采用受试者工作特征(receiver operating characteristic,ROC)曲线评估血清指标对高血压合并心力衰竭病患发生MACE的预测效能。结果与对照组相比,观察组血清NT-proBNP、D-D及AngⅡ水平显著升高(P<0.001)。与美国纽约心脏病协会(new york heart association,NYHA)分级Ⅰ~Ⅱ的病例相比,NYHA分级Ⅲ~Ⅳ的病例血清NT-proBNP、D-D及AngⅡ水平显著升高(P<0.001)。二元logistic回归分析结果显示左心室射血分数(left ventricular ejection fraction,LVEF)水平是高血压合并心力衰竭病患发生MACE的保护因素(01,P<0.05)。血清NT-proBNP及D-D联合AngⅡ预测高血压合并心力衰竭病患发生MACE的曲线下面积(area under curve,AUC)为0.952(P<0.001),灵敏度为86.36%,特异性为90.32%。结论血清NT-proBNP、D-D及AngⅡ水平与对高血压合并心力衰竭病患预后密切相关,三者联合检测对病患MACE风险具有较高的预测效能。Objective To investigate the predictive efficacy of serum N-terminal proB-type natriuretic peptide(NT-proBNP)and D-dimer(D-D)combined with angiotensin II(AngⅡ)on the risk of major adverse cardiovascular events(MACE)in patients with hypertension combined with heart failure.Methods A total of 84 cases of hypertension combined with heart failure admitted to the Third People's Hospital of Luohe from March 2018 to March 2023 were investigated.According to the occurrence of MACE within 6 months after discharge,84 cases were divided into control group(no MACE,n=62)and observation group(MACE,n=22).General data and serum NT-proBNP,D-D,and AngⅡabundance differences were analyzed between the two groups.Binary logistic regression analysis was employed to explore the independent influencing factors of MACE in patients with hypertension combined with heart failure,and receiver operating characteristic(ROC)curve was utilized to evaluate the predictive efficacy of serum indicators on MACE in patients with hypertension combined with heart failure.Results Compared with the control group,the abundance of serum NT-proBNP,D-D,and AngⅡin the observation group was significantly enhanced(P<0.001).Serum abundance of NT-proBNP,D-D,and AngⅡwas significantly higher in NYHA classⅢ~Ⅳcases than that in NYHA classⅠ~Ⅱcases(P<0.001).Binary logistic regression analysis showed that LVEF abundance was a protective factor for MACE in cases with hypertension combined with heart failure(O<OR<1,P<0.05).NYHA grade,NT-proBNP,D-D,and AngⅡlevels were risk factors for MACE in patients with hypertension combined with heart failure(OR>1,P<0.05).The area under the curve(AUC)of serum NT-proBNP and D-D combined with Ang I in predicting MACE in hypertensive patients with heart failure was 0.952(P<0.001),the sensitivity was 86.36%the specificity was 90.32%.Conclusion Serum NT-proBNP,D-D,and AngⅡabundance were closely associated with the prognosis of cases with hypertension combined with heart failure,and the combined detection of the three index

关 键 词：高血压 心力衰竭 主要不良心血管事件风险 N末端B型利钠肽前体 D二聚体 血管紧张素Ⅱ 

分 类 号：R544.1[医药卫生—心血管疾病]