N末端脑钠尿肽原预测老年人腹部手术后心脏事件的价值

目的:探讨术前血浆N末端脑钠尿肽原（NT-proBNP）水平对老年腹部手术患者围手术期严重心血管事件（PMCE）的预测价值。方法: 检测173例拟实施腹部手术老年患者的术前血浆NT-proBNP浓度，通过ROC曲线下面积比较术前血浆NT-proBNP水平和修订心脏风险指数（RCRI）在预测老年腹部手术患者围手术期发生PMCE的价值并找出理想截断点值。结果: 围手术期发生PMCE 12例，PMCE组血浆NT-proBNP浓度显著高于无PMCE组，中位数分别为452.6 ng/L和67.1 ng/L，NT-proBNP-log分别为2.72±0.43和1.82±0.39，P<0.01。术前血浆NT-proBNP的ROC曲线下面积为0.964（95%CI 0.924-0.986，P<0.01），RCRI的ROC曲线下面积为0.79（95%CI 0.722-0.848，P<0.01），二者的曲线下面积比较相差0.174，P<0.05。NT-proBNP预测围手术期PMCE的截断点为230.2 ng/L，其诊断灵敏度、特异度和准确度分别为92% 、96%和 96%。结论: 术前血浆NT-proBNP能预测老年腹部手术患者PMCE的发生，可以作为术前风险评估的工具。

Predictive value of N-terminal pro-brain natriuretic peptide for perioperative major cardiovascular events in elderly patients undergoing abdominal surgery

AIM: To investigate the value of N-terminal pro-brain natriuretic peptide(NT-proBNP) levels in predicting perioperative major cardiovascular events(PMCE) in elderly patients undergoing abdominal surgery.METHODS: NT-proBNP was determined preoperatively in 173 patients undergoing surgery.ROC analyses were performed to evaluate the predictive values of plasma NT-proBNP and revised cardiac risk index(RCRI) for perioperative PMCE in elderly patients undergoing abdominal surgery and to identify the optimal NT-pro...