降钙素原对左心室射血分数正常心力衰竭患者病情预后判断价值

目的:探讨左心室射血分数正常心力衰竭(HFPEF)患者外周血清降钙素原(PCT)水平动态变化及其对预后的预测价值。方法:选择HFPEF患者125例,入院1、2、3、5 d抽取肘静脉血检测PCT指标,并记录当日急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)、序贯器官衰竭评分(SOFA)。根据14 d生存情况分为存活组和病死组,比较2组PCT水平及APACHE Ⅱ评分、SOFA评分,并分析各指标之间的相关性。结果:病死组入院1、2 d外周血PCT水平与存活组差异均无统计学意义(P >0.05),但入院3 d和5 d PCT 水平与APACHE Ⅱ、SOFA评分均呈显著正相关关系(P<0.01)。受试者工作特征曲线显示,入院3 d PCT水平对14 d病死率有一定的预测价值,曲线下面积为0.815。结论:动态监测血PCT水平的变化有助于判断HFPEF患者的预后。

The prognosis evaluation of serum procalcitonin levels in heart failure patients with preserved ejection fraction

Objective:To investigate the prediction value of peripheral blood procalcitonin(PCT) levels in the prognosis evaluation of patients with heart failure with preserved ejection fraction(HFPEF). Methods:One hundred and twenty-five patients with HFPEF were enrolled. Serum PCT levels were monitored,and the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score,sequential organ failure assessment ( SOFA) score were recorded at the 1st,2nd,3rd and 5th day. According to the 14-day outcome after admission,the patients with HFPEF were divided into survivor group and non-survivor group,the dynamic changes of serum PCT levels, APACHE Ⅱ score and SOFA score were compared between the two groups and the correlation analysis was carried out. Results:There was no significant difference in serum PCT levels at the 1st and 2nd day between survivor group and non-survivor group(P > 0. 05),but the positive statistical correlation was found between serum PCT levels and APACHE Ⅱ score,SOFA score in non-survivor group(P <0. 01). Receiver operator characteristic curve revealed serum PCT levels on the 3rd day could significantly predict the 14-day mortality, maximal area under the curve of serum PCT was 0. 815. Conclusions:Dynamic monitoring of serum PCT levels could help to assessment the prognosis of patients with HFPEF,also to predict the severity of the illness.