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目的探讨血浆N末端B型利钠肽原(NT-proBNP)对收缩功能不全性心力衰竭(SHF)急性失代偿期患者预后的临床评估价值。方法选取该院148例SHF急性失代偿期患者为研究对象进行回顾性分析。根据随访期患者转归分为:研究组,发生心脏事件,共73例;对照组,未发生心脏事件,共75例。比较两组的NT-proBNP水平、左室舒张末期内径(LVEDd)、左室射血分数(LVEF)、再入院率与死亡率。结果与对照组相比,研究组的NT-proBNP、LVEDd、再入院率与死亡率均显著升高(均P<0.05);而LVEF明显降低。多元Logistic回归分析显示,NT-proBNP为远期心脏事件的独立预测因子。NT-proBNP预测心源性死亡ROC曲线下面积为0.792。NT-proBNP取值3 600 pmol/L预测心源性死亡的敏感度和特异度达最高。血浆BNP≤3 600 pmol/L患者生存率高于BNP>3 600 pmol/L(P<0.05)者。结论 NT-proBNP是影响SHF急性失代偿期患者预后的独立预测因素。
Objective To investigate the clinical value of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) in the prognosis of patients with acute decompensated systolic heart failure (SHF). Methods A total of 148 SHF patients with acute decompensation in this hospital were selected as the study subjects for retrospective analysis. According to the follow-up of patients were divided into: study group, cardiac events, a total of 73 cases; control group, no cardiac events, a total of 75 cases. NT-proBNP levels, left ventricular end diastolic dimension (LVEDd), left ventricular ejection fraction (LVEF), readmission rates and mortality were compared between the two groups. Results Compared with the control group, NT-proBNP, LVEDd, readmission rate and mortality in the study group were significantly increased (all P <0.05), while LVEF was significantly lower. Multiple logistic regression analysis showed that NT-proBNP was an independent predictor of long-term cardiac events. The area under the ROC curve of NT-proBNP in predicting cardiac death was 0.792. NT-proBNP value of 3 600 pmol / L predicted the highest sensitivity and specificity of cardiac death. Patients with plasma BNP ≤3 600 pmol / L had higher survival rates than those with BNP> 3 600 pmol / L (P <0.05). Conclusion NT-proBNP is an independent predictor of prognosis in acute decompensated SHF patients.