血浆NT-proBNP在收缩性心力衰竭患者急性失代偿期的预后价值

目的 研究血浆N末端B型利钠肽原（NT-proBNP）对收缩功能不全性心力衰竭（SHF）急性失代偿期患者预后的临床评估价值。方法选取我院148例SHF急性失代偿期患者为研究对象进行回顾性分析。根据随访期患者转归分为研究组（发生心脏事件，共73例）和对照组（未发生心脏事件，共75例）。比较两组的NT-proBNP水平、左室舒张末期内径（LVEDd）、左室射血分数（LVEF）、再入院率与死亡率。结果 与对照组相比，研究组的NT-proBNP、LVEDd、再入院率与死亡率均显著升高（均P〈0．05）；而LvEF明显降低。多元Logistic回归分析显示，NT-proBNP为远期心脏事件的独立预测因子。NT-proBNP预测心源性死亡ROC曲线下面积为0.792。NT-proBNP取值3600pmol／L预测心源性死亡的敏感度和特异度达最高。血浆NT-proBNP≤3600pmol/L患者生存率高于NT-proBNP〉3600pmol／L（P〈O.05）。结论 NT—proBNP是影响SHF急性失代偿期患者预后的独立预测因素。

The Prognostic Value of NT-proBNP on Admission in Patients with Acute Decompensated Systolic Heart Failure

Objective To analyze the prognostic value of NT-proBNP on admission in patients with acute decompensated systolic heart failure （SHF）. Methods The data of 148 patients with acute decompensated SHF were collected to retrospectively study. All pa tients were divided into reaserch group（compliance with cardiac events,73 cases） and control group（non-compliance with cardiac events, 75 cases）, according to the patients＇ prognosis during follow-up period. The level of NT-proBNP,left ventricular end diastolic diameter （LVEDd） ,left ventricular ejection fraction （LVEF）,readmission and mortality rate were compared. Results Compared to control group, the level of NT-proBNP,LVEDd,readmission and mortality rate were higher in research group,but LVEF was lower （P〈O.05）. Multivariant logistic analysis showed that the NT-proBNP was independent factors for cardiac events in patients with SHF. The areas under the receiver operating curve （ROC）,when NT-proBNP was used to predict cardiac death of SHF,was 0.792. For predicting cardiac death in patients with SHF, NT-proBNP cutoff point of 3600pmol/L had the best sensitivity and specificity. The survival rate of patients in group of NT-proBNP≤3600pmol/L was much higher than that in group of NT-proBNP〉3600pmol/L（P〈0.05）. Conclusion Plasma NT-proBNP is an independent predictor for prognosis of patients with acute decompensated SHF.