The diagnostic and prognostic value of MR-proADM levels in patients with chronic heart failure
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摘要: 目的：研究肾上腺髓质中段肽（MR-proADM）水平对慢性心力衰竭（心衰）的诊断及预后评估价值。方法：随机入选330例慢性心衰患者，同期选择健康体检者90例作为健康对照组。各组入组后24 h内及症状缓解后7 d均测定N末端脑钠肽前体（NT-proBNP）、MR-proADM、心脏超声（左心室内径及左心室射血分数）等，追踪随访6个月，以心衰再入院及全因死亡为终点，分为事件组与非事件组，分析MR-proADM对慢性心衰的诊断及预后评估价值。结果：与健康对照组相比，慢性心衰患者的MR-proADM水平明显升高（P<0.05）；MR-proADM水平随着心衰病情加重而升高，经药物治疗后下降，且与NT-proBNP水平有显著正相关。多元逐步回归分析显示，MR-proADM、NT-proBNP、左心室射血分数是慢性心衰患者心衰再入院及病死率的独立预测因素。ROC分析的最佳MR-proADM切点为646.31 pmol/L。结论：MR-proADM水平对慢性心衰患者的诊断及预后评估有重要的指导意义。Abstract: Objective: To study the diagnostic and prognostic value of MR-proADM levels in patients with chronic heart failure. Method: A total of 330 patients with chronic heart failure were randomly selected, and 90 healthy cases were selected as controls. Within 24 hours after entry of the group and 7 days after remission of symptoms, NT-proBNP, MR-proADM and cardiac ultrasound (left ventricular diameter and left ventricular ejection function) were measured. All the patients were followed up for 6 months, and then divided into event group and non event group according to heart failure readmission and all-cause mortality. The differences of MR-proADM and NT-proBNP were compared and the value of MR-proADM in diagnosis and prognosis of chronic heart failure was evaluated. Result: The level of MR-proADM in patients with chronic heart failure was significantly higher than that in the control group (P<0.05). The level of MR-proADM was increased with the aggravation of heart failure, and then decreased after drug treatment, MR-proADM levels were significantly positively correlated with NT-proBNP levels. Stepwise regression analysis showed that, MR-proADM, NT- proBNP and eft ventricular ejection function were independent predictors of readmission rate and mortality in patients with chronic heart failure. The ROC analysis showed that the cut point of MR-proADM was 646.31 pmol/L. Conclusion: MR-proADM level has important guiding significance in the diagnosis and prognosis evaluation of chronic heart failure.[JP]
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Key words:
- chronic heart failure /
- MR-proADM /
- diagnosis /
- prognosis evaluation
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