NT-pro BNP在老年心力衰竭合并衰弱诊断及预后评估的应用价值

doi:10.3969/j.issn.1006-6233.2024.02.016

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摘要 目的: 探究N末端B型利钠肽前体(NT-pro BNP)在老年心力衰竭合并衰弱诊断及预后评估的应用价值。方法: 以2020年1月至2022年3月老年心力衰竭115例为研究对象,根据Fried衰弱诊断量表将患者分为衰弱组、衰弱前期组及无衰弱组,分析患者NT-pro BNP水平对患者合并衰弱的诊断价值及与衰弱程度的相关性;根据患者入组12个月内主要不良事件发生情况将衰弱组分为预后较好组及预后不良组,分析NT-pro BNP水平对患者预后的评估价值。结果: 衰弱组、衰弱前期组及无衰弱组的NT-pro BNP、BNP及cTnⅠ、CK、CK-MB水平呈下降趋势,且衰弱组各指标高于衰弱前期组,衰弱前期组各指标高于无衰弱组(P<0.05);NT-pro BNP水平诊断老年心力衰竭患者合并衰弱的AUC值为0.773,95%CI为0.685~0.846,P<0.001,灵敏度为68.63%,特异度为76.56%;NT-pro BNP水平与衰弱程度呈正相关(r=0.521,P<0.001);衰弱组、衰弱前期组及无衰弱组的主要心血管不良事件发生率分为60.78%、34.62%及28.95%,其中衰弱组主要心血管不良事件发生率高于衰弱前期组及无衰弱组(P<0.05);预后不良组的NT-pro BNP、BNP及cTnⅠ、CK、CK-MB水平高于预后较好组(P<0.05);NT-pro BNP水平评估老年心力衰竭合并衰弱患者预后的AUC值为0.787,95%CI为0.650~0.889,P<0.001,灵敏度为87.10%,特异度为70.00%。结论: 老年心力衰竭合并衰弱患者的NT-pro BNP水平异常升高,且该指标对患者出现衰弱症具诊断价值,对患者预后有评估价值。

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	叶飞
	陈丹丹
	姚尧

关键词 ：心力衰竭, 老年患者, 衰弱, N末端B型利钠肽前体, 诊断价值, 预后评估价值

Abstract：Objective: To explore the application value of N-terminal pro-B-type natriuretic peptide (NT-pro BNP) in the diagnosis of elderly heart failure with frailty and assessment of prognosis. Methods: A total of 115 cases of elderly heart failure from January 2020 to March 2022 were selected. According to the Fried frailty diagnostic scale, patients were divided into frailty group, pre-frailty group, and non-frailty group. The diagnostic value of NT-pro BNP level for frailty and its correlation with frailty severity were analyzed. The frailty group was further divided into a better prognosis group and a poor prognosis group based on major adverse events occurring within 12 months of enrollment, and the prognostic value of NT-pro BNP level was analyzed. Results: The levels of NT-pro BNP, BNP, cTnⅠ, CK, and CK-MB in the frailty group, pre-frailty group, and non-frailty group showed a decreasing trend. The indicators in the frailty group were higher than those in the pre-frailty group, and the pre-frailty group was higher than the non-frailty group (P<0.05). The AUC value of NT-pro BNP level for diagnosing frailty in elderly heart failure patients was 0.773, with a 95% CI of 0.6850.889, P<0.001, sensitivity of 87.10%, and specificity of 70.00%. Conclusion: NT-pro BNP levels are abnormally elevated in elderly heart failure patients with frailty. This marker has diagnostic value for frailty and prognostic assessment in patients, providing valuable insights into their diagnosis and prognosis.

Key words： Heart failure Elderly patients Frailty N-terminal pro-B-type natriuretic peptide Diagnostic value Prognostic assessment value

基金资助:2022年度安徽省中医药传承创新科研项目,(编号:2022CCZC07)

引用本文:

叶飞, 陈丹丹, 姚尧. NT-pro BNP在老年心力衰竭合并衰弱诊断及预后评估的应用价值[J]. 河北医学, 2024, 30(2): 259-263.
YE Fei, CHEN Dandan, YAO Yao. Application Value of NT-pro BNP in the Diagnosis of Frailty and Prognostic Assessment in Elderly Heart Failure Patients. HeBei Med, 2024, 30(2): 259-263.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.02.016 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I2/259

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