NT-proBNP在心血管疾病高危人群中长期预后的作用

doi:10.3969/j.issn.1673-8640.2014.10.007

检验医学 ›› 2014, Vol. 29 ›› Issue (10): 1013-1018.DOI: 10.3969/j.issn.1673-8640.2014.10.007

NT-proBNP在心血管疾病高危人群中长期预后的作用

莫惠芳, 吴炯, 宋斌斌, 张春燕, 王蓓丽, 刘晓文, 郭玮, 潘柏申

复旦大学附属中山医院检验科,上海 200032

收稿日期:2014-02-10 出版日期:2014-10-30 发布日期:2014-10-22
通讯作者: 潘柏申,联系电话:021-64041990-2376。
作者简介:莫慧芳,女,1969年生,学士,主管技师,主要从事临床生化检验工作。
基金资助:
“十二五”国家科技支撑计划资助项目(2012BAI37B01); 国家临床重点检验专科建设项目资助

The role of NT-proBNP in high-risk cardiovascular patients for long-term prognosis

MO Huifang, WU Jiong, SONG Binbin, ZHANG Chunyan, WANG Beili, LIU Xiaowen, GUO Wei, PAN Baishen.

Department of Clinical Laboratory, Zhongshan Hospital, Fudan University, Shanghai 200032, China

Received:2014-02-10 Online:2014-10-30 Published:2014-10-22

摘要/Abstract

摘要：

目的了解氨基末端B型钠尿肽原(NT-proBNP)水平对于胸闷胸痛患者发生心血管死亡事件的预示意义。方法检测急诊入院的288例胸闷胸痛患者的实验室相关生化免疫项目[包括心肌肌钙蛋白T、NT-proBNP、C反应蛋白、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、载脂蛋白A、脂蛋白(a)、肌酸激酶、肌酸激酶同工酶MM亚型],采用两组间t检验、秩和检验以及卡方检验分析出有差异的检测项目,再结合3年后对手术患者电话随访调查结果进行Logistic回归以及受试者工作特征(ROC)曲线分析。结果随访发现术后3年期间内发生心血管死亡事件的患者其术前血清NT-proBNP水平显著高于未发生者(P<0.001)。Logistic回归分析显示NT-proBNP水平可以作为预示心血管死亡事件发生的危险因素,其优势比(OR)为1.97[95%可信区间(CI):1.14~3.39,P=0.015]。在心血管高危人群的NT-proBNP四分位组中, NT-proBNP水平对人群中心血管事件再入院的发生也具有预示作用。NT-proBNP水平与年龄具有一定的相关性。ROC曲线显示NT-proBNP的曲线下面积(AUC)为0.714(95%可信区间为0.504~0.925),可作为预示心血管死亡的指标。结论心血管疾病高危患人群的术前NT-proBNP水平能够预示这一人群中发生心血管死亡事件的风险。

关键词: 氨基末端B型钠尿肽原, 随访, 预后

Abstract:

Objective To investigate the role of N-terminal B-type natriuretic peptide (NT-proBNP) level for predicting cardiovascular death events in patients with chest distress and chest pain. Methods A total of 288 patients who were going to emergency with chest distress and chest pain were enrolled. The cardiac troponin T, NT-proBNP, C-reactive protein, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein A, lipoprotein(a), creatine kinase and creatine kinase-MM were determined. The statistical methods contained t test, rank sum test and Chi-square test. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed. Resutls The serum NT-proBNP in the cardiovascular death event follow-up group for 3 years was higher than that without events (P<0.001). Logistic regression analysis showed that NT-proBNP can be as the prediction risk factor for cardiovascular death events, and the odds ratio was 1.97 [95% confidence interval (CI): 1.14-3.39, P=0.015]. Among the 4 groups which were classified by the quarter level of NT-proBNP, the level of NT-proBNP can also predict the readmission to hospitals in the follow-ups. The level of NT-proBNP was related with ages. The ROC curve showed that the area under the curve (AUC) of NT-proBNP was 0.714 (95%CI: 0.504-0.925), which can be as a predictive parameter for cardiovascular death events. Conclusions The level of NT-proBNP before the treatment can be used to predict the occurrence of cardiovascular death events in high-risk cardiovascular patients.

Key words: N-terminal B-type natriuretic peptide, Follow-up, Prognosis

中图分类号:

R446.1

莫惠芳, 吴炯, 宋斌斌, 张春燕, 王蓓丽, 刘晓文, 郭玮, 潘柏申. NT-proBNP在心血管疾病高危人群中长期预后的作用[J]. 检验医学, 2014, 29(10): 1013-1018.

MO Huifang, WU Jiong, SONG Binbin, ZHANG Chunyan, WANG Beili, LIU Xiaowen, GUO Wei, PAN Baishen.. The role of NT-proBNP in high-risk cardiovascular patients for long-term prognosis[J]. , 2014, 29(10): 1013-1018.

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NT-proBNP在心血管疾病高危人群中长期预后的作用

The role of NT-proBNP in high-risk cardiovascular patients for long-term prognosis

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