Serum NT-proBNP and homocysteine levels in prognosis assessment of patients with heart failure
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摘要: 目的:探讨氨基末端B型脑钠肽前体 (NT-proBNP) 联合血清同型半胱氨酸 (HCY) 检测在心力衰竭 (心衰) 患者治疗和预后评估中的临床应用价值。方法:选取我院161例心衰患者作为研究组, 50例健康对照为我科健康体检的受试者 (对照组)。观测指标为治疗前及治疗后的左室射血分数 (LVEF)、NT-proBNP、HCY水平。共随访1年, 分别于第6个月和第12个月时采患者静脉血检测NT-proBNP和HCY水平, 并记录患者心源性不良事件 (心源性再入院和心源性死亡) 的发生情况, 通过COX风险回归分析随访1年患者的数据, 确认NTproBNP和HCY水平与不良事件发生的关系;受试者工作特征曲线 (ROC) 确定观察指标预测不良事件发生的最佳截断值。结果:研究组的NT-proBNP和HCY水平[(6 986.56±103.78) pg/ml和 (19.44±5.78) μmol/L]较对照组更高, 治疗后研究组的LVEF有所改善[(50.57±13.67)%:(36.54±8.65)%, P＜0.05], NT-proBNP水平[(924.61±88.56) pg/ml:(6 986.56±103.78)) pg/ml, P＜0.05]和HCY水平[(12.21±1.86) μmol/L:(19.44±5.78) μmol/L, P＜0.05]均显著降低。患者心源性不良事件的发生与NT-proBNP和HCY水平呈正相关, NT-proBNP ≥ 2 853.14pg/ml且HCY ≥ 15.87μmol/L时提示不良事件发生的可能性极高。结论:NTproBNP联合HCY检测可预测心衰患者心源性不良事件的发生。
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关键词:
- 心力衰竭 /
- 预后 /
- 氨基末端B型脑钠肽前体 /
- 同型半胱氨酸
Abstract: Objective: To assess the clinical value of N-terminal-pro-brain natriuretic peptide (NT-proBNP) and homocysteine (HCY) in prognosis assessment of patients with heart failure.Method: Left ventricular ejection fraction (LVEF), NT-proBNP and HCY levels were measured in 161 patients with heart failure and 50 healthy individuals, namely observed group and control group respectively.Cardiac death and re-admission events were recorded, and NT-proBNP and HCY levels were measured every month for a one-year follow-up.COX analysis was used to assess the relationship between observed indicator and adverse event.The areas under ROC curve of NT-proBNP and HCY levels in prognosis assessment of patients with heart failure were evaluated.Result: The levels of NTproBNP [(6 986.56±103.78) pg/ml vs (324.56±34.63) pg/ml, P＜0.05] and HCY [(19.44±5.78) μmol/L vs (8.36±1.93) μmol/L, P＜0.05] in the observed group were significantly higher than that in the control group.When heart failure was controlled, the LVEF level was significantly increased [(50.57±13.67)% vs (36.54±8.65)%, P＜0.05], while the levels of NT-proBNP [(924.61±88.56) pg/ml vs (6 986.56±103.78)) pg/ml, P＜0.05] and HCY [(12.21±1.86) μmol/L vs (19.44±5.78) μmol/L, P＜0.05] were decreased.There exist a positive relationship between observed indicator and adverse event.The NT-proBNP level above 2 853.14 pg/ml and HCY level above 15.87μmol/L can indicate adverse event.Conclusion: NT-proBNP and HCY detection can indicate adverse event in prognosis of patients with heart failure.-
Key words:
- heart failure /
- prognosis /
- NT-proBNP /
- homocysteine
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