文献类型：期刊文献

中文题名：血清氨基末端脑钠肽前体、白蛋白和同型半胱氨酸与射血分数保留型心力衰竭患者预后的相关性

英文题名：Correlation between serum N-terminal brain natriuretic peptide,albumin and homocysteine with prog?nosis of patients with heart failure with preserved ejection fraction

作者：韩晶晶[1];王国林[1];李侃[1];赵信科[2]

第一作者：韩晶晶

机构：[1]兰州市第一人民医院心血管内科,兰州730050;[2]甘肃中医药大学附属医院心血管内科,兰州730050

第一机构：兰州市第一人民医院心血管内科,兰州730050

年份：2022

卷号：28

期号：1

起止页码：63

中文期刊名：岭南心血管病杂志

外文期刊名：South China Journal of Cardiovascular Diseases

收录：CSTPCD

基金：国家自然科学基金项目(项目编号:81860786)。

语种：中文

中文关键词：心力衰竭;预后;氨基末端脑钠肽前体;白蛋白;同型半胱氨酸

外文关键词：heart failure;prognosis;N-terminal brain natriuretic peptide;albumin;homocysteine

摘要：目的探讨血清氨基末端脑钠肽前体(N-terminal brain natriuretic peptide,NT-proBNP)、白蛋白(albu?min,Alb)和同型半胱氨酸(homocysteine,Hcy)与射血分数保留型心力衰竭(heart failure with preserved ejection fraction,HFPEF)患者预后的相关性。方法选取2017年1月至2018年12月兰州市第一人民医院心血管内科收治的120例HFPEF患者作为研究对象,收集所有患者首次住院时的临床资料并随访18个月,以心源性死亡和(或)心力衰竭再入院作为终点事件,将其分为事件组(n=70)和非事件组(n=50)。对比两组患者血清NT-proBNP、Alb和Hcy浓度差异,绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)分析NT-proBNP、Alb和Hcy在HFPEF患者预后中的临床价值;NT-proBNP、Alb和Hcy对HFPEF预后的影响采用多元Logistic回归分析进行分析。结果与非事件组患者比较,事件组患者血清NT-proBNP和Hcy浓度升高,血清Alb浓度降低,差异均有统计学意义(P<0.05)。ROC分析发现,血清NT-proBNP、Alb和Hcy浓度均可辅助预测HFPEF患者预后(均有P<0.05),此时截断值分别为6785.29 pg/mL、40.28 g/L和46.71μmol/L,曲线下面积(AUC)分别为0.712(95%CI:0.674~0.785)、0.695(95%CI:0.617~0.768)和0.736(95%CI:0.684~0.786);三者联合诊断效能提高,曲线下面积为0.868(95%CI:0.809~0.935)。多元Logistic回归分析发现,NT-proBNP、Alb和Hcy均是影响HFPEF终点事件[心源性死亡和(或)心力衰竭再入院]发生的独立因子(均有P<0.05)。结论血清NT-proBNP、Alb和Hcy是HFPEF患者终点事件发生的独立因子,均可预测其发生,三者联合效果更佳。
Objectives To investigate the correlations of serum concentrations of N-terminal brain natriuretic peptide(NT-proBNP),albumin(ALB)and homocysteine(Hcy)with the prognosis of patients with heart failure with preserved ejection fraction(HFPEF).Methods Totally 120 patients with HFPEF admitted to The First People′s Hospital of Lanzhou City from January 2017 to December 2018 were selected as the research objects.The clinical data of all the patients at the first hospitalization were collected and followed up for 18 months.Cardiac death and(or)heart failure readmission were taken as the end events.The patients were divided into event group(n=70)and non event group(n=50).The differences of serum concentrations of NT-proBNP,ALB and Hcy were compared between the two groups.The receiver operating characteristic curve(ROC)was drawn to analyze the clinical value of NT-proBNP,ALB and Hcy in the prognosis of HFPEF;the multivariate Logistic regression was used to analyze the influence of NT-proBNP,ALB and Hcy on the prognosis of patients with HFPEF.Results Compared with non event group,serum concentrations of NT-proBNP and Hcy in event group increased,while serum concentration of ALB in event group decreased(P<0.05).The ROC analysis showed that serum concentrations of NT-proBNP,ALB and Hcy could predict the prognosis of HFPEF(all P<0.05),and the cutoff values were 6785.29 pg/mL,40.28 g/L and 46.71μmol/L respectively.The area under curve(AUC)were 0.712(95%CI:0.674-0.785),0.695(95%CI:0.617-0.768)and 0.736(95%CI:0.684-0.786)respectively.The combined diagnosis efficiency of the three methods was improved,and the AUC was 0.868(95%CI:0.809-0.935).The multivariate Logistic regression analysis showed that NT-proBNP,ALB and Hcy were independent factors influencing the end-point events[cardiac death and(or)readmission for heart failure]of patients with HFPEF(all P<0.05).Conclusions Serum concentrations of NT-proBNP,ALB and Hcy are independent factors of endpoint events in patients with HFPEF,which can be used to predict the occurrence of endpoint events in patients with HFPEF,and the combined effect of the three factors is better.