血浆NT-proBNP评估舒张性心衰合并糖尿病患者预后的价值

目的：探讨血浆 N末端B型利钠肽原（NT-proBNP）评估舒张功能不全性心力衰竭（DHF）合并2型糖尿病（T2DM）患者预后的价值。方法：回顾性分析我院206例住院的 DHF合并 T2DM患者资料，依据转归结局不同分为：无事件组108例，事件组98例[发生主要心血事件（MACE）]。检测并比较两组患者住院期间 NT-proB-NP、糖化血红蛋白（HbA1c）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）水平以及左室舒张末期内径（LVEDd）、左室舒张早期/舒张晚期峰值流速（E/A）比值、左室射血分数（LVEF）值。结果：与无事件组相比，事件组的 NT-proBNP、LVEDd显著增加，LVEF、E/A比值明显降低（P 均＜0.05），单因素直线分析显示 NT-proBNP、HbA1c、LVEDd、E/A比值与 MACE发生率呈正相关（r＝0.075～0.091，P均＜0.05），多元 Logistic回归分析显示，NT-proBNP为 MACE的独立预测因子（OR＝1.003，P＝0.009）。NT-proBNP预测患者住院死亡的 ROC曲线下面积为0.803（P＜0.05），血浆 NT-proBNP≤4010pg/ml者的生存率明显高于 NT-proBNP＞4010 pg/ml者（OR＝5.028，P＜0.05）。结论：血浆 N末端 B型利钠肽原能独立预测舒张功能不全性心力衰竭合并2型糖尿病患者的预后。

Value of plasma NT-proBNP assessing prognosis of patients with diastolic heart failure complicated dia-betes mellitus

Objective：To explore value of plasma N terminal pro B type natriuretic peptide （NT-proBNP）assessing prognosis of patients With diastolic heart failure （DHF）complicated type 2 diabetes mellitus （T2DM）.Methods：The folloW-up data of 206 inpatients With DHF and T2DM from our hospital Were retrospectively analyzed.Ac-cording outcome,they Were divided into no event group （n=108）and event group [n=98,With major adverse car-diovascular events （MACE）occurred].Levels of NT-proBNP,glycosylated hemoglobin （HbA1c）,total cholesterol （TC）and loW density lipoprotein cholesterol （LDL-C）,left ventricular end-diastolic dimension （LVEDd）,left ventricular peak early diastolic velocity/peak late diastolic velocity （E/A）and left ventricular ejection fraction （LVEF）during admission Were measured and compared betWeen tWo groups. Results：Compared With no event group,there Were significant increase in NT-proBNP level and LVEDd,and significant decrease in LVEF and E/A in event group （P〈0.05 all）.Single factor linear analysis indicated that NT-proBNP,HbA1c,LVEDd and E/A Were positively correlated With MACE incidence rate （r=0.075-0.091,P〈0.05 all）.Mutivariate Logistic regres-sion analysis indicated that NT-proBNP Was an independent predictor for MACE （OR=1.003,P=0.009）.Areaunder recieve operating characteristic curve （ROC）Was 0.803 for NT-proBNP predicting mortality of patients during admission （P 〈0.05）,and survival rate of patientsWith plasma NT-proBNP≤4010pg/mlWas significantly higher than that of patients With NT-proBNP〉4010 pg/ml （OR=5.028,P 〈0.05）.Conclusion：Plasma NT-proBNP can independently predict prognosis of patients With diastolic heart failure complicated type 2 diabetes mellitus.