cTnⅠ与NT-ProBNP联合检测对充血性心力衰竭预后评估的意义

目的：探讨联合检测血浆肌钙蛋白Ⅰ（cTnⅠ）和N末端B型钠尿肽（NT-ProBNP）对心力衰竭患者预后的评估价值。方法：选择本院2012年1-11月住院的心脏病患者共161例，入院后24 h内进行cTnⅠ和NT-ProBNP同步测定。根据cTnⅠ、NT-ProBNP结果将患者分为三组吗，A组：cTnⅠ、NT-ProBNP均低于临界点；B组：cTnⅠ、NT-ProBNP其中之一高于临界点；C组：cTnⅠ、NT-ProBNP均高于临界点。出院后随访1年，指标包括心功能恶化再住院或心力衰竭恶化死亡。结果：心衰越重患者NT-ProBNP升高越明显，组间比较差异有统计学意义（P〈0.01）。cTnⅠ在心功能Ⅳ级组与心功能Ⅰ、Ⅱ、Ⅲ级组比较，差异有统计学意义（P〈0.05）。随访结果：B组与A组比较，再住院率差异有统计学意义（P〈0.01），死亡率差异无统计学意义；C组与A组比较，再住院率差异有统计学意义（P〈0.01），死亡率差异有统计学意义（P〈0.01）。结论：联合检测血浆cTnⅠ和NT-ProBNP，更能准确预测心衰患者预后，对心力衰竭患者预后的评估价值更高。

The Assessment of Prognosis in Combined Detection of cTn I and NT-ProBNP on Congestive Heart Failure

Objective：To explore the assessed value of combined detection of cTn Ⅰ and NT-ProBNP on the Congestive Heart Failure（CHF）. Method：161 inpatients with CHF attended our hospital from Jan. 2012 to Nov. 2012 were simultaneous measured cTnⅠand NT-ProBNP within 24 hours after being hospitalized. 161 patients were divided into three groups according to the result：A group（ both the content of cTnI and NT-ProBNP were less than cut off point ）;B group（either cTn Ⅰor NT-ProBNP was higher than cut off point）;C group（both cTn Ⅰand NT-ProBNP were higher than cut off point ）. Patients had been followed up one year since they were out of the hospital,which indices including re-hospitalization caused by cardiac function becoming worse or death caused by CHF. Result：The worse CHF was,the higher the content of NT-ProBNP was（P〈0.01）. There was significant statistic difference between the heart function gradeⅣand gradeⅠ,Ⅱ,Ⅲin aspect of the content of cTnⅠ（P〈0.05）. Result of following up：there was significant difference between the group B and group A in terms of re-hospitalization rate A（P〈0.01）,but no in death rate（P＆gt;0.05）. While there were significant difference between the group C and group A in terms of both re-hospitalization rate and death rate（P〈0.01）. Conclusion：Combined detection of plasma cTnⅠand NT-ProBNP could best predict the prognosis of patient with CHF with higher assessment value.