血清Hcy NT-proBNP水平与慢性心力衰竭患者心律失常的相关性

doi:10.3969/j.issn.1006-6233.2021.10.022

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摘要 目的:分析血清同型半胱氨酸(Hcy)、N末端B型脑钠肽(NT-proBN)水平与慢性心力衰竭(CHF)患者心律失常的相关性,旨在为进一步探讨CHF患者发生心律失常的病理机制,为临床早期检出及治疗方案的制定提供依据。方法:回顾性分析宿州市第一人民医院2019年1月至12月住院接诊的76例CHF患者病历资料,根据是否伴有心律失常进行分组,将未伴有心律失常患者45例纳入非心律失常组,将伴有心律失常患者31例纳入心律失常组。另选取本院同期入院体检的健康者30例纳入对照组。详细记录受检者一般资料、血脂、血肌酐(Cr)、血清Hcy及NT-proBNP水平。采用Pearson方法检验血清Hcy与NT-proBNP相关性;采用一般线性回归分析得到线性回归方程,检验血清Hcy、NT-proBNP水平对CHF患者发生心律失常的影响,并绘制ROC曲线得到曲线下面积,检验血清Hcy、NT-proBNP水平在CHF患者心律失常预测中的价值。结果:心律失常组血清Hcy、NT-proBNP水平高于非心律失常组、对照组,差异有统计学意义(P<0.05);非心率失常组血清Hcy、NT-proBNP水平高于对照组,差异有统计学意义(P<0.05);经双变量Pearson相关性检验显示,CHF发生心律失常患者血清Hcy与NT-proBNP成正相关(r=0.371,P<0.001);经线性回归分析检验得到线性回归方程:Y(Hcy)=0.717＋0.063X,Y(NT-proBNP)=1.016＋0.002X,血清Hcy与NT-proBNP可能是诱发CHF患者发生心律失常的影响因素(P<0.05);将CHF患者发生心律失常作为状态变量,绘制ROC曲线,结果显示,血清Hcy、NT-proBN水平预测CHF患者心律失常发生的曲线下面积分别为:0.857(95%CI:0.775~0.939)、0.913(95%CI:0.860~0.965),灵敏度为86.71%、90.00%、特异度68.45%、71.10%。结论:血清Hcy、NT-proBNP水平与CHF患者心律失常密切相关,且可能是CHF患者发生心律失常的影响因素,临床中评估CHF患者血清Hcy、NT-proBNP水平,在预测心律失常发生具有较高的应用价值。

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	孟成
	吕磊
	周跟东

关键词 ：慢性心力衰竭, 血清同型半胱氨酸, N末端B型脑钠肽, 心律失常

Abstract：Objective: To analyze the correlation between serum homocysteine (Hcy), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and arrhythmia in patients with chronic heart failure (CHF), aiming to further investigate the pathological mechanism of arrhythmia in patients with CHF, and to provide a basis for early clinical detection and development of treatment plans. Methods: The medical data of 76 CHF patients were retrospectively analyzed. According to whether there was arrhythmia or not, 45 patients without arrhythmia were included in the non-arrhythmia group, and 31 patients with arrhythmia were included in the arrhythmia group. Another 30 healthy people who were admitted to the hospital for physical examination during the same period were selected as the control group. The general data, blood lipid, serum creatinine (Cr), serum Hcy and NT-proBNP levels of the subjects were carefully recorded. The Pearson method was used to test the correlation between serum Hcy and NT-proBNP. The general linear regression analysis was used to obtain the linear regression equation to test the effect of serum Hcy and NT-proBNP levels on the occurrence of arrhythmia in patients with CHF. The area under the curve was obtained by plotting the ROC curve, and the value of serum Hcy and NT-proBNP levels in the prediction of arrhythmia in patients with CHF was tested. Results: The levels of serum Hcy and NT-proBNP in the arrhythmia group were higher than those in the non-arrhythmia group and the control group, with a statistical significant difference (P<0.05); the levels of serum Hcy and NT-proBNP in the non-arrhythmia group were higher than those in the control group, with a statistical significant difference (P<0.05); the bivariate Pearson correlation test showed that serum Hcy was positively correlated with NT-proBNP in CHF patients with arrhythmia (r=0.371, P<0.001); the linear regression equation was obtained by linear regression analysis: Y (Hcy)=0.717+0.063X, Y (NT-proBNP)=1.016+0.002X, and serum Hcy and NT-proBNP may be the influencing factors for inducing arrhythmia in patients with CHF (P<0.05); the arrhythmia in CHF patients was used as a state variable, and the ROC curve was plotted, and the results showed that the areas under the curve of serum Hcy and NT-proBN levels in predicting the occurrence of arrhythmia in CHF patients were 0.857 (95%CI: 0.775-0.939) and 0.913 (95%CI: 0.860-0.965), the sensitivity was 86.71% and 90.00%, and the specificity was 68.45%, 71.10%, respectively. Conclusion: Serum Hcy and NT-proBNP levels are closely related to arrhythmia in patients with CHF, which may be the influencing factors for arrhythmia in patients with CHF. Clinical evaluation of serum Hcy and NT-proBNP levels in patients with CHF has higher application value in predicting the occurrence of arrhythmia.

Key words： Chronic heart failure Serum Hcy NT-proBNP Arrhythmia

基金资助:安徽省合肥市卫生健康应用医学研究项目,(编号:合卫科教〔172-4〕号)

通讯作者: 周跟东

引用本文:

孟成, 吕磊, 周跟东. 血清Hcy NT-proBNP水平与慢性心力衰竭患者心律失常的相关性[J]. 河北医学, 2021, 27(10): 1687-1691.
MENG Cheng, LV Lei, et al. An Analysis of the Correlation Between Serum Hcy NT-ProBNP Levels and Arrhythmia in Patients with Chronic Heart Failure. HeBei Med, 2021, 27(10): 1687-1691.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.10.022 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I10/1687

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