老年严重失代偿期急性心力衰竭外周血NRG-1 NT-proBNP CRP水平变化及与预后的关系

doi:10.3969/j.issn.1006-6233.2023.12.09

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Abstract Objective: To investigate the changes of peripheral blood Neuromodulation protein 1 (NRG-1), N-terminal pro B-type natriuretic peptide (NT proBNP), C-reactive protein (CRP) levels in elderly patients with severe decompensated acute heart failure and their relationship with prognosis. Methods: A total of 128 elderly patients with severe decompensated acute heart failure who were treated in our hospital from January 2021 to February 2022 were selected as the observation group, while 100 patients with chronic heart failure were selected as the control group, the levels of peripheral blood NRG-1, NT-proBNP, and CRP were compared between the two groups. The differences in peripheral blood NRG-1, NT-proBNP, and CRP levels among patients with different clinical characteristics in the observation group were analyzed, as well as the differences in clinical characteristics and peripheral blood NRG-1, NT-proBNP levels and CRP levels of dead and surviving patients. Results: The peripheral blood NRG-1 of the observation group was (936.61±204.40) pg/ml, which was significantly lower than that of the control group (P<0.05), while NT proBNP and CRP were (3611.88±505.52) pg/ml and (28.77±8.05) mg/L, respectively, which was significantly higher than that of the control group (P<0.05). The peripheral blood NRG-1 of NYHA grade IV patients in the observation group was (1106.65±210.41) pg/ml, which was significantly lower than the control group (P<0.05), while NT proBNP and CRP were (3410.45±541.15) pg/ml and (24.40±9.94) mg/L, respectively, which was significantly higher than the control group (P<0.05). The peripheral blood NRG-1 of patients with LVEF<40% in the observation group was (1014.46±201.45) pg/ml, which was significantly lower than that of patients with LVEF ≥ 40% (P<0.05), while NT proBNP and CRP were (3521.08±500.78) pg/ml and (25.71±8.38) mg/L, respectively, which was significantly higher than those of patients with LVEF>40% (P<0.05). Peripheral blood NRG-1 was positively correlated with LVEF (r=0.477, P<0.05), while NT proBNP and CRP levels were negatively correlated with LVEF (r=-0.398 and -0.466, P<0.05). The proportion of dead patients aged ≥ 80 years, the proportion of NYHA grade IV patients, and the proportion of LVEF<40% in the observation group were 70.00%, 65.00%, and 85.00%, respectively, which were significantly higher than those of surviving patients (P<0.05). The peripheral blood NRG-1 of the observation group's deceased patients was (924.54±194.65) pg/ml, which was significantly lower than that of the surviving patients (P<0.05), while the levels of NT-proBNP and CRP were (3681.54±445.54) pg/ml and (27.84±6.15) mg/L, respectively, which was significantly higher than those of the surviving patients (P<0.05). Logistic regression analysis showed that NYHA grading, LVEF, NRG-1, NT proBNP, and CRP were influencing factors for patient mortality (P<0.05). Conclusion: The peripheral blood NRG-1 levels in elderly patients with severe decompensated acute heart failure decrease, while the levels of NT-proBNP and CRP increase, are related to the patient's cardiac function grading and LVEF, and are also influencing factors for patient prognosis.

Key words： Elderly Period of loss of compensation Acute heart failure Neuromodulation protein 1 N-terminal B-type natriuretic peptide precursor C-reactive protein Prognosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.12.09 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I12/1978

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