血浆NT-proBNP、血清ST2与急性失代偿性心力衰竭预后评估

目的 观察急性失代偿性心力衰竭（ADHF）患者血浆NT-proBNP和血清ST2水平变化,探讨其与ADHF患者预后的关系.方法 选取2011年7月～2012年4月期间急诊科就诊的ADHF患者75例（心衰组）,根据预后分为事件组30例及非事件组45例;选取同期健康体检者42例为对照组.检测并比较血浆NT-proBNP、血清ST2、CK-MB、cTnI及超声心动图等指标.结果 ADHF患者NT-proBNP、ST2均高于对照组（P＜0.01）;事件组NT-proBNP、ST2和cTnI均高于非事件组（P＜0.01或P＜0.05）;NT-proBNP、ST2和cTnI与预后呈正相关.Logistic回归分析显示,NT-proBNP B=1.61,P＜0.01,OR=4.43,95％CI=（2.20～10.98）]和ST2B=1.7,P＜0.01,OR=2.03,95％CI（1.47～4.16）]是不良预后的独立预测因子.结论 NT-proBNP、ST2水平升高是ADHF患者不良预后的危险因素.

The Plasma NT-proBNP and Serum ST2 of Acute Decompensated Heart Failure Patients for Evaluation of Prognosis

Objective To study plasma NT-proBNP and serum ST2 of acute decompensated heart failure patients （ADHF） for evaluation of the prognosis. Methods Seventy-five patients with ADHF （HF group） were selected from July 2011 to April 2012 in the emergency department. Patients were divided according to the prognosis into the events of 30 cases, the non-events of 45 patients, and 42 normal healthy people were used as controls. Their plasma levels of NT-proBNP and serum levels of ST2 ,as well as plasma levels of CK-MB,cTnI were measured and echocardiography were perforomed and compared, Results The NT-proBNP and ST2,of ADHF group were higher than the control group （P〈0.01）. In events group. NT-proBNP, ST2, and cTnI were higher than the non-events group （P〈0.01 or P〈0.05）. NT-proBNP, ST2 and cTnI were positively correlated with the outcome. Logistic regression showed that NT-proBNP was B= 1.61, P〈0.01,OR=4.43,95 %CI= 2.20-10.98 and ST2 was B=1.7, P〈0. 01, OR = 2.03,95% CI= 1.47-4. 16. Conclusion High level of NT-proBNP and ST2 are risk factors for adverse outcomes in patients with ADHF.