中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2015年
1期
113-115
,共3页
N末端脑钠肽前体%收缩性心力衰竭%急性失代偿期%高龄
N末耑腦鈉肽前體%收縮性心力衰竭%急性失代償期%高齡
N말단뇌납태전체%수축성심력쇠갈%급성실대상기%고령
N-terminal pro brain natriuretic peptide%Systolic heart failure%Acute decompensated periode%Elderly patients
目的：探讨血浆N末端脑钠肽前体（NT-proBNP）对高龄收缩功能不全性心力衰竭（SHF）急性失代偿期患者预后判断价值。方法纳入128例SHF急性失代偿期高龄患者，根据NT-proBNP数值四分位数法分成四组，为Q1~Q4组，每组32例，随访6月。依据预后结局不同分为：对照组（70例），未再入院；研究组（58例），再入院或死亡。比较组间左室射血分数（LVEF）、左室缩短率（LVFS）、左室收缩末期容量指数（LVESVI）、6分钟步行距离及再入院率与死亡率的差异。应用受试者工作曲线（ROC）分析NT-proBNP对预后的最佳预测值。结果 Q1~Q4组的LVESVI、再入院率及死亡率顺序依次为：Q4最高、Q3次之、Q1最低（P＜0.05），而LVEF、LVFS及6分钟步行距离水平顺序依次为：Q1最高、Q2次之、Q4最低（P＜0.05）。随访6月时，与对照组比较，研究组患者NT-proBNP及LVESVI显著增高（P＜0.05），而LVEF、LVFS及6分钟步行距离则降低（P＜0.05）。ROC曲线显示NT-proBNP对患者短期发生死亡的曲线下面积（AUC）为0.826，血浆NT-proBNP≤205 ng/L死亡率高于NT-proBNP＞205 ng/L。结论 NT-proBNP能独立评估SHF急性失代偿期高龄患者的病情及近期预后结局。
目的：探討血漿N末耑腦鈉肽前體（NT-proBNP）對高齡收縮功能不全性心力衰竭（SHF）急性失代償期患者預後判斷價值。方法納入128例SHF急性失代償期高齡患者，根據NT-proBNP數值四分位數法分成四組，為Q1~Q4組，每組32例，隨訪6月。依據預後結跼不同分為：對照組（70例），未再入院；研究組（58例），再入院或死亡。比較組間左室射血分數（LVEF）、左室縮短率（LVFS）、左室收縮末期容量指數（LVESVI）、6分鐘步行距離及再入院率與死亡率的差異。應用受試者工作麯線（ROC）分析NT-proBNP對預後的最佳預測值。結果 Q1~Q4組的LVESVI、再入院率及死亡率順序依次為：Q4最高、Q3次之、Q1最低（P＜0.05），而LVEF、LVFS及6分鐘步行距離水平順序依次為：Q1最高、Q2次之、Q4最低（P＜0.05）。隨訪6月時，與對照組比較，研究組患者NT-proBNP及LVESVI顯著增高（P＜0.05），而LVEF、LVFS及6分鐘步行距離則降低（P＜0.05）。ROC麯線顯示NT-proBNP對患者短期髮生死亡的麯線下麵積（AUC）為0.826，血漿NT-proBNP≤205 ng/L死亡率高于NT-proBNP＞205 ng/L。結論 NT-proBNP能獨立評估SHF急性失代償期高齡患者的病情及近期預後結跼。
목적：탐토혈장N말단뇌납태전체（NT-proBNP）대고령수축공능불전성심력쇠갈（SHF）급성실대상기환자예후판단개치。방법납입128례SHF급성실대상기고령환자，근거NT-proBNP수치사분위수법분성사조，위Q1~Q4조，매조32례，수방6월。의거예후결국불동분위：대조조（70례），미재입원；연구조（58례），재입원혹사망。비교조간좌실사혈분수（LVEF）、좌실축단솔（LVFS）、좌실수축말기용량지수（LVESVI）、6분종보행거리급재입원솔여사망솔적차이。응용수시자공작곡선（ROC）분석NT-proBNP대예후적최가예측치。결과 Q1~Q4조적LVESVI、재입원솔급사망솔순서의차위：Q4최고、Q3차지、Q1최저（P＜0.05），이LVEF、LVFS급6분종보행거리수평순서의차위：Q1최고、Q2차지、Q4최저（P＜0.05）。수방6월시，여대조조비교，연구조환자NT-proBNP급LVESVI현저증고（P＜0.05），이LVEF、LVFS급6분종보행거리칙강저（P＜0.05）。ROC곡선현시NT-proBNP대환자단기발생사망적곡선하면적（AUC）위0.826，혈장NT-proBNP≤205 ng/L사망솔고우NT-proBNP＞205 ng/L。결론 NT-proBNP능독립평고SHF급성실대상기고령환자적병정급근기예후결국。
Objective To investigate the predictive value of plasma N-terminal pro brain natriuretic peptide (NT-proBNP) to prognosis in elderly patients with acute decompensated systolic heart failure (ADSHF). Methods ADSHF patients (n=128) were chosen and divided into 4 groups (Q1 group to Q4 group, each n=32). After followed up for 6 m and according to prognosis, the patients were divided into control group (n=70, non-readmission) and research group (n=58, readmission or death). The difference in left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), left ventricular end-systolic volume index (LVESVI), 6-minute walk test (6MWT), readmission rate and mortality were compared among all groups. The best predictive value of NT-proBNP to prognosis was analyzed by using receiver operating curve (ROC). Results LVESVI, readmission rate and mortality were in a descending order from Q4 group, Q3 group to Q1 group (P<0.05), and LVEF, LVFS and 6MWT were in a descending order from Q1 group, Q2 group to Q4 group (P<0.05). After follow-up for 6 m, NT-proBNP and LVESVI increased significantly (P<0.05), and LVEF, LVFS and 6MWT decreased (P<0.05) in research group compared with control group. ROC analysis showed that area under curve (AUC) of short-term mortality predicted by NT-proBNP was 0.826. The mortality of patients with NT-proBNP≤205 ng/L was higher than those with NT-proBNP>205 ng/L. Conclusion NT-proBNP can independently review the severity and short-term prognosis in patients with ADSHF.
