联合检测NT-proBNP 肌酐血红蛋白对慢性心力衰竭患者预后的预测价值

doi:10.3969/j.issn.1006-6233.2023.10.011

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摘要 目的:分析NT-proBNP、肌酐、血红蛋白对慢性心力衰竭患者预后的预测价值。方法:回顾性分析我院收治的2020年3月至2021年3月220例CHF患者的临床资料,随访1年,根据患者预后是否并发不良事件,将其分为预后良好组(n=141)和预后不良组(n=79)。比较两组患者的NT-proBNP、肌酐、血红蛋白水平,并通过多因素Logistic回归法对CHF患者预后的危险因素进行分析,采用Pearson法分析病例组血清NT-proBNP、肌酐、血红蛋白与左室射血分数(LVEF)、左心室舒张末内径(LVEDD)的相关性,受试者工作特征(ROC)曲线下面积(AUC)评价NT-proBNP、肌酐、血红蛋白对预测CHF预后的价值。结果:NT-proBNP、肌酐水平预后不良组高于预后良好组(P<0.05),血红蛋白水平预后不良组低于预后良好组(P＜0.05);多因素逐步二元Logistic回归分析显示,患者的NT-proBNP、肌酐、血红蛋白水平是影响CHF预后的独立危险因素(P<0.05);Pearson相关分析结果显示,CHF患者NT-proBNP、肌酐、血红蛋白与LEVF、LVEDD明显相关(P<0.05);随着NYHA分级的增加,NT-proBNP、肌酐水平逐渐升高(P<0.05),血红蛋白水平逐渐下降(P<0.05);ROC曲线显示,NT-proBNP、肌酐、血红蛋白及三者联合预测CHF预后的AUC为0.765、0.656、0.720、0.866,敏感度分别为60.8%、46.8%、53.2%和86.1%,特异度为83.0%、91.5%、83.7%和73.8%。结论:NT-proBNP、肌酐、血红蛋白与CHF患者心衰严重程度相关,联合检测预测CHF患者预后具有较好的效能,且联合检测比单因子检测具有更高的临床价值。

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关键词 ：氨基末端脑利钠肽, 肌酐, 血红蛋白, 慢性心衰, 预后

Abstract：Objective: To analyze the prognostic value of NT-proBNP, creatinine and hemoglobin in patients with chronic heart failure. Methods: The clinical data of 220 patients with CHF from March 2020 to March 2021 were retrospectively analyzed. The patients were followed up for 1 year and divided into good prognosis group (n=141) and poor prognosis group (n=79) according to whether the patients had concurrent adverse events. The levels of NT-proBNP, creatinine and hemoglobin in the two groups were compared, and the prognostic risk factors of CHF patients were analyzed by multivariate Logistic regression. Pearson method was used to analyze the correlation of serum NT-proBNP, creatinine and hemoglobin with left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) in the case group. The area under receiver operating characteristic (ROC) curve (AUC) evaluated the value of NT-proBNP, creatinine and hemoglobin in predicting the prognosis of CHF. Results: The levels of NT-proBNP and creatinine in poor prognosis group were higher than those in good prognosis group (P<0.05), and the levels of hemoglobin in poor prognosis group were lower than those in good prognosis group (P<0.05); Multifactor stepwise binary Logistic regression analysis showed that the levels of NT-proBNP, creatinine and hemoglobin were independent risk factors affecting the prognosis of CHF (P<0.05); Pearson correlation analysis showed that NT-proBNP, creatinine and hemoglobin were significantly correlated with LEVF and LVEDD in CHF patients (P<0.05); with the increase of NYHA grade, the levels of NT-proBNP and creatinine were increased (P<0.05), while the hemoglobin level was decreased (P<0.05); ROC curve showed that the AUC of NT-proBNP, creatinine, hemoglobin, and their combination in predicting the prognosis of CHF was 0.765,0.656,0.720,0.866, and the sensitivity was 60.8%,46.8%,53.2% and 86.1%, respectively,the specificity was 83.0%,91.5%,83.7% and 73.8%. Conclusion: NT-proBNP, creatinine and hemoglobin are correlated with the severity of heart failure in CHF patients, and the combined detection has better efficacy in predicting the prognosis of CHF patients, and the combined detection has higher clinical value than the single factor detection.

Key words： Amino-termianlpro-brain natriuretic peptide Creatinine Hemoglobin Chronic heart failure Prognosis

基金资助:河北省承德市科学技术研究与发展计划项目,(编号:202006A055)

引用本文:

王青松, 张艳敏, 王雪冬, 孙海玲, 王虹. 联合检测NT-proBNP 肌酐血红蛋白对慢性心力衰竭患者预后的预测价值[J]. 河北医学, 2023, 29(10): 1644-1649.
WANG Qingsong, ZANG Yanmin, WANG Xuedong, et al. The Prognostic Value of Combined Detection of NT-proBNP Creatinine and Hemoglobin in Patients with Chronic Heart Failure. HeBei Med, 2023, 29(10): 1644-1649.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.10.011 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I10/1644

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